RENAL ACCESS, TRACT DILATATION AND OPERATIVE TIME ARE SHORTER IN PATIENTS UNDERGOING MINI PERCUTANEOUS NEPHROLITHOTOMY (MINI PCNL) UNDER ULTRASOUND GUIDANCE

Abstract

Introduction: Traditionally, fluoroscopy is used to successfully perform various steps of PCNL. Ultrasound has emerged as new imaging modality to overcome the problem of radiation exposure associated with fluoroscopy.

Objective:  To compare the outcomes of mini PCNL using ultrasound and fluoroscopy for renal access and dilatation.

Results: This non radomised study  involved 160 patients from 1^st Jan, 2019 to 30^th Aug, 2022. Half cases (80) were performed under ultrasound (UG- mini PCNL) and  half cases (80) under fluoroscopy guidance (FG- mini PCNL). Preoperative parameters were same in both groups. The UG- mini PCNL group had higher success rate of first puncture (73.7% vs 53.7%, P = 0.01). The mean renal access time was shorter (3.2 ± 1.1 min vs 4.1 ± 1.0 min, P = < 0.005) in UG- mini PCNL group. Similarly, the tract dilatation time was shorter in UG- mini PCNL group (7.0 ± 1.2 min vs 8.0 ± 1.4 min, P = < 0.005). The operative time was shorter in UG-mini PCNL group (73.9 ± 7.3 min vs 85.8 ± 5.2 min, P = < 0.005). The mean drop in hemoglobin was lesser in UG- mini PCNL group (1.26 ± 0.4 vs 1.42 ± 0.4, P = 0.02). The stone clearance, hospital stay, complications and ancillary procedures were the same in both groups.

Conclusion: The duration of renal tract puncture, dilatation and operative time can be shortened by using ultrasound with effective stone clearance and without higher complication or bleeding rates for renal stones ? 20 mm.