Ultrasound-guided percutaneous nephrolithotomy: Advantages and limitations

Foo Cheong Ng; Wai Loon Yam; Tze Ying Benjamin Lim; Jin Kiat Teo; Kok Kit Ng; Sey Kiat Lim

추천

검색

자료유형: 학술저널

저자정보: Foo Cheong Ng (Changi General Hospital) Wai Loon Yam (Changi General Hospital) Tze Ying Benjamin Lim (Changi General Hospital) Jin Kiat Teo (Changi General Hospital) Kok Kit Ng (Changi General Hospital) Sey Kiat Lim (Changi General Hospital)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.58 No.5

발행연도: 2017.1

수록면: 346 - 352 (7page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Purpose: The use of ultrasound in percutaneous nephrolithotomy (PCNL) has not been shown to translate to better clinical and stone outcomes. To compare the operative outcomes, postoperative outcomes and complication rates of ultrasound-guided access PCNL (USGA-PCNL) versus fluoroscopy-guided access PCNL (FGA-PCNL). Materials and Methods: A total of 184 consecutive patients who underwent PCNL from July 2008 to September 2014 were identified from our PCNL database. Seventy-two patients underwent USGA-PCNL and 112 FGA-PCNL. Results: The patients were similar in age, sex, race, American Society of Anesthesiologists physical status classification, mean largest stone diameters, side of PCNL, number of stones and the degree of hydronephrosis between both groups. There were higher rates of upper pole (5.6% vs. 3.6%), mid pole (8.3% vs. 2.7%) and multiple pole punctures (4.2% vs. 0%) in USGA-PCNL compared to FGA-PCNL (p=0.027). There was no difference in the stone free rates of both groups in univariate analysis. Those who had FGA-PCNL were 2.26 (95% confidence interval, 1.09–4.75; p=0.029) times more likely to require a second-look procedure compared to USGA-PCNL on univariate analysis but not on multivariate analysis. There were no differences in Clavien-Dindo complications. No patient in the USGA-PCNL group experienced organ injuries during puncture compared to 1 patient in the FGA-PCNL group who had pneumothorax requiring urgent chest tube insertion. Conclusions: The use of ultrasonography to guide access puncture during PCNL eliminates the risk of inadvertent organ injuries. Similar operative and stone outcomes show that the learning curve for USGA is minimal compared to conventional FGA.

참고문헌 (26)

참고문헌 신청

Rao PN / 1987 / Radiation dose to patient and staff during percutaneous nephrostolithotomy / Br J Urol 59:508~512

Bowsher WG / 1992 / Radiation protection in percutaneous renal surgery / Br J Urol 69:231~233

Karamcheti A / 1977 / Percutaneous nephrolithotomy:an innovative extraction technique / J Urol 118:671~672

Zhou X / 2008 / Clinical value of minimally invasive percutaneous nephrolithotomy in the supine position under the guidance of real-time ultrasound: report of 92 cases / Urol Res 36:111~114

Hosseini MM / 2009 / Ultrasonography-guided percutaneous nephrolithotomy / J Endourol 23:603~607

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!