Background: Percutaneous nephrolithotomy (PCNL) is one of the most
common and effective methods used for removal of large renal stones. PCNL
traditionally utilizes fluoroscopy for visualizing the renal stone, creating
access, dilating the working tract, and ensuring stone clearance. Percutaneous
Nephrolithotomy (PCNL) access to the kidney is performed, mostly under XRay fluoroscopy. Providing only two- dimensional image, sometimes
includes multiple puncture trials and exposes the patient, personnel and
surgeons to ionizing radiation. The same access can be achieved under
ultrasound (US) guidance, the aim of the study is to compare Efficacy,
accuracy, complications & outcome of ultrasound guided percutaneous
nephrolithotomy (US-PCNL) with X-ray guided percutaneous
nephrolithotomy (XG-PCNL). Patients and Methods: This comparative
study was carried out on forty patients performing radiology (ultrasound /
fluoroscopy) guided percutaneous nephrolithotomy admitted in urology
department or attending emergency. They were divided as follows: Patient
group (C-PCNL): twenty patients performing fluoroscopy guided minipercutaneous nephrolithotomy. Patient group (US-PCNL): twenty patients
performing US guided mini-percutaneous nephrolithotomy. All patients with
complex calyceal, pelvic, and upper ureteral stones with stone burden of ≥ 20
mm were included (grade II -IV Guys stone score) were included in the study. Results: A current study
showed that there was statistically significant difference between C-PCNL and US-PCNL regarding stone
free rate. (45.0%) in C-PCNL and (60.0%) in US-PCNL which suggest a better stone free rate in USPCNL. Conclusion: The use of US-PCNL to guide access puncture during PCNL eliminates the risk of
inadvertent organ injuries. US-PCNL had better stone free Rate than CPCNL. |
