Aim: To evaluate PCNL in the supine position under ultrasound-guided puncture regarding its technical aspects, success rate, and complications.
Patients and Methods: The study included 47 patients. All patients with renal and or upper ureteral stones were included in this study, while patients with uncorrectable coagulopathy congenital anomalies in the kidney were excluded. PCNL in the supine position was done under ultrasound-guided puncture while dilatation was done under fluoroscopy.
Results: Twenty cases (42.5%) had pelvic stones, 18 cases (38.3%) had calyceal stones, 5 cases (10.6%) had multiple stones, 1 case (2.1%) had upper ureteic stones, and 3 cases (6.4%) had stagehorn stones. Twenty-five cases (53.2%) were right sided and 22 cases (46.8%) were left sided. Stone size was 2.9 ±1.029. Forty-two cases had radiopaque stones (89.4%), while 5 cases had radiolucent stones (10.6%). Upper calyceal puncture was done in 2 cases, middle calyceal puncture in 6 cases, lower calyceal puncture in 32 cases (68.1%), and multiple punctures in 9 cases. Stone disintigration using pneumatic lithoclast was done in 31 cases (66%), and in toto stone extraction was done in 16 cases (34%). The mean operative time was 70 minutes (60 to 120 minutes). The intraoperative complications were dilatation difficulties in 5 cases (10.6%) and bleeding requiring transfusion in 2 cases (4.2%). The stone-free rate was achieved in 44 cases (93.6%) and residual stones more than 4 mm were detected in 3 cases (6.4%). The mean hospital stay was 3.2 days (2 to 5 days). There was fever in 4 cases (8.5%) and urinary leakage in 3 cases (6.4%).
Conclusion: PCNL in the supine position under ultrasound-guided puncture is feasible, safe, and successful, with minimal complications.
Hammouda Sherif, Osama Abdelwahab, Abdelaziz Omar, Ibrahim Eraky
Submitted: November 4, 2011
Accepted for Publication: December 6, 2011
KEYWORDS: Supine position; PCNL; Stones
CORRESPONDENCE: Hammouda Waheeb Sherif, MD, Benha University, Benha Elgdeeda, Benha,11513, Egypt ( ).
CITATION: UroToday Int J. 2012 Feb;5(1):art 89.
doi: http://dx.doi.org/10.3834/uij.1944-5784.2012.02.07