Comparison of application value between X-ray and ultrasound in percutaneous nephrolithotomy for complicated renal calculi

doi:10.3877/cma.j.issn.1674-3253.2019.02.009

Abstract

Abstract:

Objective

To compare the application value between C-arm X-ray and ultrasound localization in the minimally invasive percutaneous nephrolithotomy (MPCNL) for complicated renal calculi.

Methods

Clinical data of 156 patients with complicated renal calculi admitted to our department from July 2015 to July 2017 were retrospectively analyzed. Among them, 89 patients underwent C-arm X-ray-guided MPCNL and 67 cases received ultrasound-guided MPCNL. The success rate of the first caliceal puncture, postoperative decline in hemoglobin level, stage I removal rate of renal calculi and surgical complications were analyzed.

Results

In the X-ray group, the first caliceal puncture was successfully performed for 69 patients, the hemoglobin level was decreased (16.2±7.4) g/L after operation, the stage I removal rate of renal calculi was 69.66% (62/89), and surgical complications occurred in 12 cases. In the ultrasound group, the first caliceal puncture was successfully performed for 31 patients, the hemoglobin level was declined (19.5±8.2) g/L postoperatively, the stage I removal rate of renal calculi was 62.69% (42/67), and surgical complications were found in 10 cases. The success rate of the first caliceal puncture and postoperative decline in hemoglobin level showed statistical difference between the two groups (both P<0.05). The stage I removal rate of renal calculi and surgical complications showed no statistical difference between the two groups (both P>0.05).

Conclusion

During MPCNL in the treatment of complicated renal calculi, X-ray guidance can significantly improve the success rate of the first caliceal puncture and minimize intraoperative hemorrhage while compared with ultrasound, which is an efficacious management of complicated renal calculi. Surgeons should adopt the optimal puncture approach for different patients according to the characteristics of medical equipment, surgical skills, and clinical experience.

Key words: X-ray, Ultrasound, PCNL, Renal calculi

Hailong Wang, Zongping Zhang, Anguo Wang, Ji Wu, Yunxiang Li, Shuo Tang. Comparison of application value between X-ray and ultrasound in percutaneous nephrolithotomy for complicated renal calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(02): 108-111.

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?	例数	性别（例）		年龄（岁，±s）	BMI（kg/m²，±s）	结石大小（mm，±s）	积水深度（mm，±s）
?	例数	男	女	年龄（岁，±s）	BMI（kg/m²，±s）	结石大小（mm，±s）	积水深度（mm，±s）
Ｘ线组	89	55	34	53±16	21±6	31±8	2.1±0.5
超声组	67	37	30	51±17	22±6	33±8	2.2±0.5
统计值	-	χ²=0.55		t=1.05	t=1.33	t=0.91	t=1.20
P值	?	0.41		0.30	0.19	0.36	0.23

?	例数	性别（例）		年龄（岁，±s）	BMI（kg/m²，±s）	结石大小（mm，±s）	积水深度（mm，±s）
?	例数	男	女	年龄（岁，±s）	BMI（kg/m²，±s）	结石大小（mm，±s）	积水深度（mm，±s）
Ｘ线组	89	55	34	53±16	21±6	31±8	2.1±0.5
超声组	67	37	30	51±17	22±6	33±8	2.2±0.5
统计值	-	χ²=0.55		t=1.05	t=1.33	t=0.91	t=1.20
P值	?	0.41		0.30	0.19	0.36	0.23

?	例数	首次目标盏穿刺成功率（%）	血红蛋白下降（g/L，±s）	结石取净率（%）	术中通道出血（例）	术后发热（例）	损伤邻近器官（例）
Ｘ线组	89	77.53	16±7	69.66	6	5	1
超声组	67	61.19	19±8	62.69	4	6	0
统计值	-	χ²=4.90	t=2.63	χ²=0.84	χ²=0.04	χ²=0.65	χ²=0.76
P值	?	<0.01	<0.01	0.36	0.85	0.42	0.38

?	例数	首次目标盏穿刺成功率（%）	血红蛋白下降（g/L，±s）	结石取净率（%）	术中通道出血（例）	术后发热（例）	损伤邻近器官（例）
Ｘ线组	89	77.53	16±7	69.66	6	5	1
超声组	67	61.19	19±8	62.69	4	6	0
统计值	-	χ²=4.90	t=2.63	χ²=0.84	χ²=0.04	χ²=0.65	χ²=0.76
P值	?	<0.01	<0.01	0.36	0.85	0.42	0.38

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