Study on Clinical Application of Different Ultrasound-Guided Planar Techniques in Minimally Invasive Percutaneous Nephrolithotomy

Abstract

Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

Percutaneous nephrolithotomy – the puncture

“…The few available data are very mixed. For example, the reported average puncture time ranges from a few seconds to half an hour [23] due to lack of standardisation. Percutaneous access training models principally allow the measurement of puncture performance.…”

“…Collected >10 years ago, they are outdated. FP can be performed monoplanar and in three different bi-planar variants: 'bull's eye', triangulation, and a hybrid technique with different advantages [23]. Improvement of FP techniques has four goals: reducing radiation, moving the surgeon's hands out of the radiation field, improving targeting accuracy, and stabilisation of the needle tract.…”