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Ultrasound for kidney access in percutaneous nephrolithotomy: a contemporary review.

Abstract：

:Nowadays percutaneous nephrolithotomy (PCNL) is the standard of care for renal staghorn calculus or large (>20 mm) pelvic or caliceal stones, as well as for the failure of other treatment options. This review aims to evaluate the contemporary use of ultrasound imaging in PCNL, by comparing it to conventional fluoroscopy, reviewing data regarding the complication and success rate of nephrostomy tract creation and stone free rate (SFR), as well as data concerning the learning curve for these procedures and cost indicators. The evidence acquired shows that the ultrasound guided access (USGA) is a comparable method with the classic fluoroscopic guided access (FGA), with a similar safety profile, with a significant reduction in radiation exposure, up to radiation free complete PCNL. USGA PCNL seems to lead to decreased bleeding and need for transfusion, especially when the Doppler mode is used, and also to a slightly higher SFR than conventional FGA PCNL. USGA PCNL reduces the overall costs of the procedure by about 30% and can be safely learnt and performed by urologists. For an experienced endourologist, familiar withFGA PCNL, the learning curve for shifting to USGA PCNL is of approximately 20 procedures.

journal_name

Med Ultrason

journal_title

Medical ultrasonography

authors

Iordache A,Baston C,Guler-Margaritis SS,Angelescu E,Cerempei V,Olivier T,Sinescu I

doi

10.11152/mu-1618

subject

Has Abstract

pub_date

2018-12-08 00:00:00

pages

508-514

issue

4

eissn

1844-4172

issn

2066-8643

journal_volume

20

pub_type

杂志文章,评审

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