Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a systematic review and meta-analysis

Yu, Yang; Wen, Yu; Chen, Kuan Chou; Chen, Chiehfeng

doi:10.1007/s00345-018-2443-z

Cited by 47 publications

(30 citation statements)

References 31 publications

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“…[16][17][18][19] Moreover, meta-analysis by Yang et al, even showed that ultrasound-guided PCNL had a significantly lower complication rate. 7 Our result and current evidence showed positive remarks of safety in performing X-rayfree ultrasound-guided PCNL.…”

Section: Discussionsupporting

confidence: 58%

“…A meta-analysis found a nearly identical stone-free rate between the ultrasound-guided and fluoroscopy-guided PCNL (77.3% and 78%, respectively). 7 In our case, there was no significant complication during or after the procedure. However, the patient needed to have packed red cell transfusion of 252 mL after the procedure.…”

Section: Discussionsupporting

confidence: 45%

“…6 X-ray-free ultrasoundguided PCNL has been proven to be safe, feasible, and more affordable. 4,7,8 Traditional prone position for PCNL is associated with several disadvantages, such as anaesthetic, surgical, or logistical problems. 9 Therefore, supine position has gained more popularity due to shorter operating time and less frequent circulatory or ventilatory complications.…”

Section: Introductionmentioning

confidence: 99%

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<p>X-ray-free Ultrasound-guided Percutaneous Nephrolithotomy in Supine Position Using Alken Metal Telescoping Dilators in a Large Kidney Stone: A Case Report</p>

Birowo¹,

Raharja²,

Putra³

et al. 2020

RRU

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X-ray-free ultrasound-guided percutaneous nephrolithotomy (PCNL) has been proven to be safe, feasible, and affordable. Kidney dilatation during X-ray-free ultrasound-guided PCNL is mostly using balloon dilators. This report presents our experience of performing X-rayfree ultrasound-guided PCNL in supine position using Alken metal telescopic dilators in a patient with a large kidney stone. A 50-year-old male presented with right complete staghorn stone sized 46×30×24 mm (stone burden: 50,985 mm 3 with sphere formula) and grade II hydronephrosis. The computed tomography (CT) scan showed no right ureteric stone, kinking, or stenosis. Ureteral catheter and guidewire were placed retrogradely under ultrasound guidance during cystoscopy. Normal saline was pumped via the ureteral catheter to make artificial hydronephrosis thus assisting the process. Kidney dilatation was performed with Alken metal telescoping dilators. Urine flow from the dilators confirmed that our dilator had reached the collecting system. The stone was identified and fragmented with combination of both pneumatic and shock pulse lithotripter. Double J stent and nephrostomy tubes were inserted at the end of the procedure. All of the steps were performed purely under ultrasound guidance. There was no residual stone after the procedure, confirmed by ultrasound, nephroscope, and postoperative Xray. There was no significant complication during or after the procedure. The patient was discharged on postoperative day two. X-ray-free ultrasound-guided PCNL in supine position using Alken metal telescoping dilators seems to be a feasible, safe, and cost-effective approach in managing kidney stones, including staghorn and large stones.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionsupporting

confidence: 45%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>X-ray-free Ultrasound-guided Percutaneous Nephrolithotomy in Supine Position Using Alken Metal Telescoping Dilators in a Large Kidney Stone: A Case Report</p>

Birowo¹,

Raharja²,

Putra³

et al. 2020

RRU

View full text Add to dashboard Cite

show abstract

“…A non-contrast CT was done at the end of the 1st postoperative month. The stone-free status was defined as no stone detectable or the presence of fragments <4 mm on non-contrast CT imaging [12]. A stone-free rate (SFR) was reported for the single PCNL intervention.…”

Section: Methodsmentioning

confidence: 99%

Safety of Upper Pole Puncture in Percutaneous Nephrolithotomy with the Guidance of Ultrasonography versus Fluoroscopy: A Comparative Study

et al. 2020

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Introduction: The aim of this study was to compare the safety of ultrasonography-guided (UG) puncture and fluoroscopy-guided (FG) upper pole access (UPA) in percutaneous nephrolithotomy (PCNL). Methods: Consecutive patients with a solitary UPA were enrolled into the study from 2012 to 2020 and analyzed in a retrospective manner. In total, 177 patients were divided into 2 groups according to the method during the puncture phase of the access: FG (n = 105) and UG (n = 72). The UG and FG groups were compared in terms of complications (i.e., pleural injury and blood transfusion rate) and surgical outcomes. Results: Gender, side, grade of hydronephrosis, type of access (i.e., supracostal vs. subcostal), Guy's stone score, age, stone diameter, skin-to-stone distance, and stone density were similar in the 2 groups (p > 0.05). Only in 25.9% of cases, UPA was done using a subcostal approach. The overall complication rates were similar between the groups (p > 0.178). For the UG and FG groups, the rate of pleural injury (8.5 vs. 4.1%) and the blood transfusion rate (8.5 vs. 2.8%) were also similar (p > 0.05). The fluoroscopy time and mean hemoglobin drop were significantly lower in the UG group than in the FG group (134.2 vs. 82.2 s, respectively, p = 0.001; 20.8 ± 9.8 vs. 16.8 ± 7.9 g/L, respectively, p = 0.001). Stone-free rate (SFR) was also similar in the FG and UG groups (77.1 vs. 75.0%, respectively, p = 0.742). Conclusion: While it is commonly expected that the complication rates are lower in UG puncture for UPA in PCNL than they are in FG puncture, the present study failed to show this difference. However, the radiation exposure time seemed to be lower in UG puncture than FG puncture and had a similar stone-free rate (SFR) for UPA in PCNL.

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“…Stone complexity is a known predictor of postoperative bleeding after PCNL; however, whether the STONE score correlates with postoperative hemoglobin drop is not known. In this study, the correlation between the STONE score and postoperative hemoglobin drop was assessed among patients undergoing PCNL [10]. We hope our findings will help in counseling patients regarding transfusion requirement, hospital stay, and the possible need for embolization.…”

Section: Introductionmentioning

confidence: 96%

The Correlation Between STONE Nephrolithometry Score and Hemoglobin Drop in Patients Undergoing Percutaneous Nephrolithotomy

Shoaib

Bangash

Salam

et al. 2020

Cureus

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Ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a systematic review and meta-analysis

Cited by 47 publications

References 31 publications

<p>X-ray-free Ultrasound-guided Percutaneous Nephrolithotomy in Supine Position Using Alken Metal Telescoping Dilators in a Large Kidney Stone: A Case Report</p>

<p>X-ray-free Ultrasound-guided Percutaneous Nephrolithotomy in Supine Position Using Alken Metal Telescoping Dilators in a Large Kidney Stone: A Case Report</p>

Safety of Upper Pole Puncture in Percutaneous Nephrolithotomy with the Guidance of Ultrasonography versus Fluoroscopy: A Comparative Study

The Correlation Between STONE Nephrolithometry Score and Hemoglobin Drop in Patients Undergoing Percutaneous Nephrolithotomy

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