Beni-Suef University Journal of Basic and Applied Sciences (Jan 2024)

Ultrasound-guided percutaneous nephrolithotomy versus conventional c-arm-guided percutaneous nephrolithotomy: a prospective randomized comparative study

  • Akram A. Elmarakbi,
  • Ahmed M. Gaber Mohamed,
  • Amr M. Massoud,
  • Ahmed Abdelbary,
  • Rabie M. Ibrahim

DOI
https://doi.org/10.1186/s43088-024-00468-y
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 8

Abstract

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Abstract Background Ultrasound guidance for renal access in percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure. The current study compared the safety and effectiveness of ultrasound-guided PCNL (US-PCNL) for renal stone therapy versus fluoroscopy-guided PCNL (FL-PCNL) in prone position. Results Successful puncture was attained in all cases in both groups. Unlike fluoroscopy, US guidance reduced the time needed for achieving renal puncture that was (22.45 ± 6.95 s) compared to fluoroscopy that was (68.28 ± 56.76 s) (P value < 0.001). The mean duration of access that was reported in our study was (3.92 ± 0.72 min) in the US-PCNL group and (4.03 ± 0.77 min) in the FL-PCNL group (P value 0.460). There was no significant difference in the total operative time between both groups in our study as the mean operative time in the US-PCNL group was (61.47 ± 6.07 min) and (65.86 ± 20.86 min) in the FL-PCNL group with a (P value of 0.349). Stone-free rate was nearly similar in both groups (P value 0.336). Three cases in our study in the FL-PCNL group had bleeding that required blood transfusion post-operative; mean Hb change was 0.23 g/dL and 0.55 g/dL in US-PCNL and FL-PCNL groups, respectively, which is clinically irrelevant despite statistical significance (P value 0.007). Mean fluoroscopy time was (6.38 ± 3.84) minutes in FL-PCNL group. Conclusion Ultrasound guidance is a reliable tool in the hands of experienced urologists in performing PCNL with less or even zero radiation.

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