To explore the application value of CT combined with intravenous urography (IVU) pre-positioning corrected real-time ultrasound positioning in the establishment of percutaneous nephroscopic channel for percutaneous nephrolithotomy (PCNL) beginners.

A total of 128 adult patients with kidney or upper ureteral calculi treated in our department from January to November, 2016 were enrolled and divided into the preoperative positioning group and control group. In the preoperative positioning group (n=68), the puncture path and puncture point were designed before surgery according to CT and IVU. Intraoperatively, the pre-determined puncture point was corrected under ultrasound monitoring to establish a working channel. In the control group (n=60), intraoperative real-time ultrasound positioning was carried out. The establishment time of percutaneous nephroscopic channel, operation time, hemoglobin loss, primary calculus removal rate and incidence of other complications were statistically compared between the two groups.

Before surgery, no statistical significance was noted in sex ratio, age, calculus size, calculus surface area and body mass index between the two groups. Postoperatively, the primary calculus removal rate, hemoglobin loss and interventional therapy did not significantly differ between the two groups. The channel establishment time in the preoperative positioning group was significantly shorter than that in control group (P<0.05). In control group, 1 case received hemostasis with interventional therapy after operation. The operation time in the preoperative positioning group was slightly shorter than that in control group without statistical significance.

CT combined with IVU pre-positioning corrected by reat-time ultrasound positioning can select the optimal puncture path, improve the puncture accuracy and shorten the channel establishment time, which is worthy of application in primary hospitals.