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Ultrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study.

Abstract：

BACKGROUND AND PURPOSE:Gaining access to the pyelocaliceal system in percutaneous nephrolithotomy (PCNL) is routinely performed using fluoroscopic guidance with the patient in a prone position. We compared ultrasonography-guided access for PCNL with the patient in the flank position with conventional fluoroscopy-guided access. PATIENTS AND METHODS:A total of 60 patients were randomly separated into two 30-patient groups--namely, ultrasonography-guided access with the patient in the flank position as group 1, and fluoroscopy-guided access with the patient in the prone position as group 2. In group 1, the entire procedure was performed under ultrasonography guidance. RESULTS:Successful access was achieved 100% in both groups. The success rate was 86.7% in group 1 and 90% in group 2 (P = 0.45). The residual stone rate (stone >or=4 mm) was 13.3% in group 1 and 10% in group 2. The access duration was 14.5 +/- 2.6 minutes and 9.4 +/- 2.3 minutes in groups 1 and 2, respectively (P < 0.05). No significant differences for complications without any adjacent injuries were detected in both groups. Furthermore, the average hospital stay was 2.7 +/- 0.3 and 2.9 +/- 0.3 days accordingly for groups 1 and 2 (P = 0.89). CONCLUSION:Ultrasonography has a high ability to access calculi more easily through the pyelocaliceal system with the patient in the flank position. It is convenient for urologists, and the return to the supine position is possible easily when necessary. Besides, PCNL under ultrasonography guidance and with the patient in the flank position has high success rates and limited complications; hence, we recommend this technique as an alternative procedure for fluoroscopy-guided PCNL.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Karami H,Rezaei A,Mohammadhosseini M,Javanmard B,Mazloomfard M,Lotfi B

doi

10.1089/end.2009.0099

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

1357-61

issue

eissn

0892-7790

issn

1557-900X

journal_volume

pub_type

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Ultrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study.