Login to Access Video or Poster Abstract: MP75-15
Sources of Funding: None

Introduction

Balloon dilation with fluoroscopic guidance when gaining percutaneous renal access is generally regarded as the safest technique in western countries. However, a major drawback of fluoroscopy is the radiation. Herein, we introduce the safety and effectiveness of ultrasound monitored balloon dilation in the establishment of percutaneous renal access, based on our experience.

Methods

A retrospective study was performed of patients who underwent percutaneous nephrolithotomy (PCNL) by using ultrasound monitored balloon dilation in our center from December 2014 to May 2016. Data of the patients were analyzed, such as age, sex, stone burden, operative time, operation success, and postoperative findings. The severity of surgical complication was determined according to the Modified Clavien Classification System (MCCS).

Results

135 patients (69 male and 66 female) with a mean age of 51.6 years (range 34-74 years) were included in this study. Mean size of the largest stone diameter was 36.3mm (range 22.1-48.9mm). A total of 169 percutaneous renal tracts were gained in 142 kidneys. Successful tracts gained by balloon dilation to the collecting system was 94.7% (160/169). All procedures were successfully completed with no major complications during operation. Mean operative duration was 67min (range 51-148min). Mean temperature and mean postoperative hemoglobin drop on the 1st postoperative day were 37.5? (range 36.5-39.6?) and 1.2g/dl (range 0.1-3.2g/dl), respectively. Clavien I complications were noted in 50 cases (transient hematuria in 22 patients, fever in 28 patients), while Clavien II complications were noted in 2 cases (hematuria in 2 patients requiring pharmacological treatment). No major complications (Clavien III-V) occurred. The stone-free rate of PCNL was 82.96% (112/135).

Conclusions

Our experience demonstrates that real time whole course monitored ultrasound guided percutaneous renal access establishment using balloon dilation was safe and efficient because of its high stone-free rate and low operative time, compared to literatures. It could help to avoid exposition to radiation, not increase the risks of infection, bleeding and postoperative complications. Patients with a hydronephrotic collecting system or target calyx are more suitable for this procedure.

Funding

None