OUTCOME OF ULTRASOUND GUIDED PCNL IN THE TREATMENT OF RENAL STONES

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Abstract

ABSTRACT
Objectives: To evaluate the outcome of ultrasound guided percutaneous nephrolithotomy for the treatment of renal
stones.
Patients And Methods: This descriptive study was conducted in institute of kidney diseases Hayat Abad medical
complex Peshawar from January 2011 to January 2012 over 83 patients. A 6 Fr ureteral catheter was inserted into the
target ureter in supine position. In prone position the desired calyx is punctured with 18 gauge needle. Its presence in
calyceal system is confirmed by suctioning it through 10 cc disposable syringes. The tract was dilated with serial and
metallic telescopic dilators. The leakage of fl uid around metallic dilatators indicated the right tract.
Results: Mean age was 31.6(range 14 to 63 years).Most of the patients 46(55.42%) were having right kidney stones.
The targeted calyces were upper, middle and lower calyces in 17(20.48%), 12(14.57%) and 51(61.44%) patients. More
than one calyx was targeted In 3 (3.61%) patients. stone-free rate was (75) 90.3%. Four patients (4.81%) have 10 to 13
mm residual stones, which were cleared in 8 weeks through ESWL. In one patient 9 mm stone passed to the ureter
during PCNL, which was cleared with URS. Three patients (3.61%) had clinically insignificant residual stones which
cleared spontaneously in 4 week time. Postoperative bleeding was observed in 4(4.81%) patients. Three patients were
managed by blood transfusion and one by selective angioembolization.
Conclusion: PCNL using sonography is a good alternative to the fl uoroscopic method. It is performed without radiation
exposure to the surgeon and patient; however, more experience is needed.
Keywords: Percutaneous Nephrolithotomy (PCNL), ultrasound guidance, renal stones

Authors: 
Ata Ur Rehman
Tariq Ahmad

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