Login to Access Video or Poster Abstract: MP68-16
Sources of Funding: none

Introduction

Objective: To evaluate the efficiency and validity of type-B ultrasound guided prone position percutaneous nephrolithotomy (PCNL) accessed by two-step dilation.

Methods

Methods: A total of 11 507 patients with 12 203 kidneys or upper ureter calculi underwent PCNL accessed by two-step dilation percutaneous nephrolithotomy between June 2006 to Sept 2016, including 524 patients with solitary kidney, 204 with kidney cysts, 132 with horseshoe kidney, 78 with vertebral column deformity, 84 with medullary sponge kidney and 12 transplanted kidney. Stone burdens were (46.1± 34.5) mm in length.

Results

Results: 98.1% of 12 203 operations were successful in one-session access, in which 10 922 PCNLs were accessed by single tract (89.5%), 1 048 by double tracts (8.5%) and 87 by triple-tracts (0.7%). The mean operating time was (65.4± 31.8) min, the mean first accessing time were (16.5±12.0) min and the mean calculi-dealing time were (36.1± 52.4) min. The stone-free rate after one session operation was 98.2% for single calculus and 71.4% for multiple or staghorn calculi. Of all the kidneys, 1 122 (9.2%) accepted another PCNL to remove the residual calculi, and the last stone-free rate of PCNL was 87.5%. During and after operation, 156 cases (1.2%) needed transfusion, 89 (0.7%) underwent selective embolization of renal artery. No injury of organs occurred except for 9 (0.07%) cases with pneumatothorax and 9 (0.07%) with septic shock.

Conclusions

Conclusion: PCNL accessed by SVOF two-step dilation with ultrasound-guided prone position puncture is effective and safe.

Funding

none