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Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

Percutaneous nephrolithotomy (PCNL) is feasible in the extremely elderly patients. However, there were higher rate of complications and longer hospitalizations. The case presented is a 95-year-old female who was admitted to the hospital and was diagnosed with multiple stones in the right kidney and upper ureter with right renal effusion and infection, urosepsis, and chronic bronchitis. After sufficient preoperative preparation, small-tract PCNL under vacuum suctioning was performed using the left lateral position under combined lumbar spinal and epidural anesthesia. The patient recovered and was discharged smoothly on schedule. Good clinical and social effects have achieved.

Objective: To determine an efficient method for treating upper ureteral impacted stones, we compared the outcome of minimally invasive percutaneous nephrolithotomy (MPCNL) with the aid of our patented system (PMPCNL), traditional MPCNL, and transurethral ureteroscopy. PATIENTS AND Methods: From September 2009 to Septmber 2014, 4 hospitals in China had executed this prospective multicenter study. A total of 273 patients with complicated impacted upper ureteral stones above the level of L4 were randomly divided into 3 groups. Group 1 included 91 patients who were treated with MPCNL with the aid of a patented system. Group 2 included 91 patients who were treated with traditional MPCNL .Group3 included 91 patients who were treated with ureteroscopy. The patients underwent postoperative shock wave lithotripsy, when necessary. The operative time, stone clearance rate, operative complication markers (amount of intraoperative bleeding and postoperative fever rate), and cost of treatment were compared.Results: A significantly shorter operative time, greater rate of stone clearance, lower need for postoperative shock wave lithotripsy, and lower rate of postoperative fever was found in group 1 and group 2 compared to group 3 (p<0.05). However, the cost of treatment and amount of intraoperative bleeding in groups 1 and 1 were significantly greater. PMPCNL group was superior to MPCNL group in terms of operation time, incidence of postoperative fever, and stone-free rate by one surgery. Conclusion:MPCNL with the aid of the patented system could be the first choice in treating complicated impacted upper ureteral stones above the level of L4.