Application of Prepuncture on the Double-tract Percutaneous Nephrolithotomy Under Ultrasound Guidance for Renal Staghorn Calculi: First Experience - 11/04/18
Abstract |
Objective |
To evaluate the effect of prepuncture on the double-tract percutaneous nephrolithotomy (PCNL) under ultrasound guidance for renal staghorn calculi.
Method |
Double-tract or even multi-tract is necessary for the treatment of staghorn calculi. However, intraoperative injury, exudation, bleeding, and influence of original tract might lead to difficulty in second puncture, thus prolonging operating time, and even lead to puncture failure. We retrospectively reviewed the records of 178 patients with renal staghorn calculi who received double-tract PCNL in our department. Sixty-three patients received non–prepuncture double-tract PCNL (group A) and 115 patients underwent prepuncture double-tract PCNL (group B). In group A, the second tract was established after failing to further fragment by the first tract. In group B, based on the preoperative computed tomography, intravenous pyelography, and intraoperative ultrasound images, 2 optimal punctual positions were set. The first guidewire was manipulated in the pelvicalyceal system after successful puncture. However, we routinely performed the other puncture and a preplaced second wire was put into the collecting system as a potential second tract.
Results |
The mean operating time was longer in group A than that in group B (P = .033). There was no statistical difference between group A and group B in postoperative instant stone-free rate and final stone-free rate. In the non–prepuncture double-tract PCNL group, blood transfusion rate was 7.9% (5/63) and it was only 1.7% (2/115) in the prepuncture double-tract PCNL group (P = .042).
Conclusion |
In the treatment of renal staghorn calculi, prepuncture double-tract PCNL can shorten operating time and reduce the occurrence of blood transfusion events. This new method might be worth generalizing.
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Financial Disclosure: The authors declare that they have no relevant financial interests. |
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Funding Support: This work was supported by the State Key Laboratory of Guangdong Province (No. 2010A060801016), the Natural Science Foundation of China (No. 51403074), the Youth Fund of Jilin Provincial Science & Technology Department(Nos. 20160520144JH and 20160520146JH), and Norman Bethune Program of Jilin University(Nos. 2015324 and 2015423). Dr. Yanbo Wang is funded by Chinese Scholarship Council. |
Vol 114
P. 56-59 - avril 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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