Ultrasound-guided percutaneous nephrolithotomy versus conventional c-arm-guided percutaneous nephrolithotomy: a prospective randomized comparative study

• Published in: Beni-Suef University Journal of Basic and Applied Sciences Vol. 13; no. 1; pp. 10 - 8
• Main Authors: Elmarakbi, Akram A., Gaber Mohamed, Ahmed M., Massoud, Amr M., Abdelbary, Ahmed, Ibrahim, Rabie M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2024; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Blood transfusion; Blood transfusions; C-arm guided; Calculi; Catheters; Comparative analysis; Comparative studies; Fluoroscopy; Hemoglobin; Hydronephrosis; Kidney stones; Kidneys; Lithiasis; Lithotripsy; Medicine; Medicine & Public Health; Nephrolithiasis; Percutaneous nephrolithotomy; Prone position; Radiation; Stone-free rate; Ultrasonic imaging; Ultrasound; Urological surgery; X-rays; United States > US; Stone-free rate; C-arm guided; Ultrasound; Percutaneous nephrolithotomy
• ISSN: 2314-8543; 2314-8535; 2314-8543
• DOI: 10.1186/s43088-024-00468-y

Background Ultrasound guidance for renal access in percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure. The current study compared the safety and effectiveness of ultrasound-guided PCNL (US-PCNL) for renal stone therapy versus fluoroscopy-guided PCNL (FL-PCNL) in prone position. Results Successful puncture was attained in all cases in both groups. Unlike fluoroscopy, US guidance reduced the time needed for achieving renal puncture that was (22.45 ± 6.95 s) compared to fluoroscopy that was (68.28 ± 56.76 s) ( P value < 0.001). The mean duration of access that was reported in our study was (3.92 ± 0.72 min) in the US-PCNL group and (4.03 ± 0.77 min) in the FL-PCNL group ( P value 0.460). There was no significant difference in the total operative time between both groups in our study as the mean operative time in the US-PCNL group was (61.47 ± 6.07 min) and (65.86 ± 20.86 min) in the FL-PCNL group with a ( P value of 0.349). Stone-free rate was nearly similar in both groups ( P value 0.336). Three cases in our study in the FL-PCNL group had bleeding that required blood transfusion post-operative; mean Hb change was 0.23 g/dL and 0.55 g/dL in US-PCNL and FL-PCNL groups, respectively, which is clinically irrelevant despite statistical significance ( P value 0.007). Mean fluoroscopy time was (6.38 ± 3.84) minutes in FL-PCNL group. Conclusion Ultrasound guidance is a reliable tool in the hands of experienced urologists in performing PCNL with less or even zero radiation.