Munich, Germany (UroToday.com) Percutaneous access to the kidney is traditionally performed under fluoroscopy. The side effects of radiation exposure to the patients and operating room are well known. There has been a trend towards using lower radiation methodologies during PCNL. Ultrasound is a completely radiation free imaging modality that allows the surgeon to obtain access during PCNL.
Bochkareva and colleagues evaluated the feasibility, safety and efficacy of completely ultrasound guided renal access for percutaneous nephrolithotomy.
Authors’ represent one of the leading institutions for ultrasound guided PCNL in Russia. A total of 377 patients were involved in the study, of these 377 patients underwent ultrasound guided PCNL.
There were no differences in demographics and baseline clinical characteristics between the two groups. The primary outcomes of the study was stone free rate following the single stage procedure. Secondary outcomes of the study were intraoperative parameters and complications.
There was a significant difference in primary outcomes between the two groups. Fluoroscopy guided PCNL group had a stone free rate of 70% vs. 83.2% in ultrasound guided group. Secondary outcomes, complications after the procedure were surprisingly high representing 36.1% for fluoroscopy group and and 39.3% for ultrasound guided group 2 (p=0,47). Authors reported that majority of these complications were Clavien grade I. There were no major complications or deaths.
In conclusions, authors stated that ultrasound guided renal access and completely ultrasound PCNL procedure is feasible with acceptable complications rates and stone free rates. Ultrasound access is widely encouraged to be used during PCNL in order to reduce the radiation exposure to the patient and operating room staff.
Presented By:
Bochkareva O.
Nizhniy Novgorod State Medical Academy, Dept. of Surgical Diseases, Nizhny Novgorod, Russia
Reported by
Zhamshid Okhunov, MD, at the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany
UC Irvine Urology