Ultrasound guided percutaneous nephrolitho-111 tripsy


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Abstract

The study was aimed to the evaluation of the effectiveness and results of ultrasound guided percutaneous nephrolithotripsy (PNL) for the treatment of patients with large stones in renal pelvis. The results of PNL in 138 patients who underwent surgery for kidney stones from 2011 to 2013 were analyzed. Seventy patients (Group 1) underwent surgery with combined ultrasound and radiological guidance, and 68 patients (Group 2) - only with ultrasound guidance. The study included patients with large renal pelvic stones larger than 2.2 cm, requiring the formation of a single laparoscopic approach. Using the comparative analysis, the timing of surgery, the number of intra- and postoperative complications, blood loss and length of stay were evaluated. Percutaneous access was successfully performed in all patients. Postoperative complications (exacerbation of chronic pyelonephritis, gross hematuria) were observed in 14.3% of patients in Group 1 and in 14.7% of patients in Group 2. Bleeding requiring blood transfusion, and injuries of adjacent organs were not registered. Efficacy of PNL in the Group 1 was 95.7%; 3 (4.3%) patients required additional interventions. In Group 2, the effectiveness of PNL was 94.1%, 4 (5.9%) patients additionally underwent extracorporeal lithotripsy. There were no significant differences in the effectiveness of PNL, the volume of blood loss and duration of hospitalization. Ultrasound guided PNL can be performed in large pelvic stones and sufficient expansion of renal cavities, thus reducing radiation exposure of patients and medical staff.

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About the authors

B. G Guliev

Northwestern State Medical University n.a. I.I.Mechnikov

Email: gulievbg@mail.ru
MD, Prof. at the Department of Urology St. Petersburg

References

  1. Комяков Б.К., Гулиев Б.Г., Алексеев М.Ю. и др. Чрескожное эндоскопическое лечение камней единственной и пересаженной почки. Урология. 2011; 5: 55-60.
  2. Мартов А.Г. Перкутанная хирургия коралловидного нефролитиаза. I Российский конгресс по эндоурологии. Материалы. М., 2008; 197-198.
  3. Теодорович О.В., Шатохин М.Н., Борисенко Т.Г. и др. Современная лечебная тактика при билатеральном коралловидном нефролитиазе. Урология. 2013; 5: 70-73.
  4. Хасигов А.В., Белоусов И.И., Коган М.И. Сравнительный анализ эффективности и безопасности перкутанной нефролитотрипсии при коралловидных камнях. Урология. 2013; 1: 86-88.
  5. Armagan A., Tepeler A., Silav M.S. et al. Micropercutaneous nephrolithotomy in the treatment of moderate size renal calculi. J. Endourol. 2013; 27 (2): 177-181.
  6. Taylor E.R., Kramer B., Frye T.P. et al. Ocular radiation exposure in modern urological practice. J. Urol. 2013; 190 (1): 139-143.
  7. Wagner L.K., Eifel P.J., Geise R.A. Potential biological effects following high X-ray dose interventional procedures. J. vasc. Interv. Radiol. 1994; 5: 71-84.
  8. Rao P.N., Faulkner K., Sweeney L.K. et al. Radiation dose to patient and staff during percutaneous nephrolithotomy. Br. J. Urol. 1987; 59: 508.
  9. Smith D.L., Heldt J.P., Richards G.D. et al. Radiation exposure during continuous and pulsed fluoroscopy. J. Endourol. 2013; 27: 384.
  10. Chodick G., Bekiroglu N., Hauptmann M. et al. Risk of cataract after exposure to low doses of ionizing radiation: a 20-year prospective cohort study among US radiologic technologists. Am. J. Epidemiol. 2008; 168: 620.
  11. Milacic S. Rosk of occupational radiation-induced cataract in medical workers. Med Lav. 2009; 100: 178.
  12. Ritter M., Krombach P., Martinschek A. et al. Radiation exposure during endourologic procedures using over-the-table fluoroscopy sources. J. Endourol. 2012; 26: 47.
  13. Gamal W.M., Hussein M., Aldasshoury M. et al. Solo ultrasonography-guided percutaneous nephrolithotomy for single stone pelvis. J. Endourol. 2011; 25 (4): 593-596.
  14. Osman M., Wendt-Nordahl G., Neger K. et al. Percutaneous nephrolithotomy with ultrasonography-guided renal access: Experience from over 300 cases. BJU Int. 2005; 96: 875-878.
  15. Hosseini M., Hassanpour A., Farzan R. et al. Ultrasonography-guided percutaneous nephrolithotomy. J. Endourol. 2009; 23: 603-607.
  16. Desai M. Ultrasonography-guided punctures-with and without puncture guide. J. Endourol. 2009; 23: 1641-1643.
  17. Теодорович О.В. Чрескожная пункционная нефростомия и нефролитотомия. Дисс. канд. мед. наук. М., 1989. 205 с.
  18. Loree J., Koturbash I., Kutanzi K. et al. Radiation-induced molecular changes in rat mammary tissue: Possible implications for radiation-induced carcigenesis. Int. J. Radiat. Biol. 2006; 82: 805-815.
  19. Basiri A., Ziaee A.M., Kianian H.R. et al. Ultrasonographic versus fluoroscopic access for percutaneous nephrolithotomy: A randomized clinical trial. J. Endourol. 2008; 22: 281-284.
  20. Etemidian M., Amjadi M., Simforoosh N. Transcutaneous ultrasound guided nephrolithotomy: The first report from Iran. Urology. 2004; 1: 82-84.
  21. Zhou X., Gao X., Wen J. et al. Clinical value of mininally invasive percutaneous nephrolithotomy in the supine position under the guidance of real-time ultrasound: Report of 92 cases. Urol Res. 2008; 36: 111 - 114.

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