Department of Urology, Sohag University, Sohag, Egypt.
J Endourol. 2011 Apr;25(4):593-6. doi: 10.1089/end.2010.0558. Epub 2011 Mar 13.
To evaluate the success and outcomes of solo ultrasonography (US)-guided percutaneous nephrolithotomy (PCNL) for management of a single stone pelvis.
From April 2008 to April 2010, the procedure was applied to 34 patients (22 men and 12 women) whose ages ranged from 25 to 55 years (mean 29.5 y) with unilateral single stone pelvis in a moderately to markedly dilated pelvicaliceal system (PCS). The stone size ranged from 20 to 30 mm (mean 24 mm). Middle caliceal puncture and dilation were performed in all cases by an experienced urologist under US guidance with a needle-guided system attached to the side wall of the US probe. The evaluation of the procedure included the success of accessing the stones, the occurrence of intraoperative or postoperative complications, the stone-free rate, and the need for auxiliary maneuver.
The access was successful in all cases. Minor intraoperative complications occurred in two cases where PCS perforation was detected and was managed conservatively by Double-J stent insertion for 4 weeks. The only reported postoperative complication was fever in five cases that responded to antibiotic treatment. Thirty-two (94%) patients were stone free on postoperative day 2; significant residual stones (8 and 10 mm) were detected in two patients who underwent shockwave lithotripsy, and they became stone free within 10 days.
Solo US-guided PCNL can be performed safely as an alternative to the fluoroscopy-guided PCNL for single stone pelvis in a moderately to markedly dilated PCS by an experienced urologist.
评估单独超声引导经皮肾镜取石术（PCNL）治疗单个肾盂结石的成功率和结果。
2008 年 4 月至 2010 年 4 月，对 34 例年龄 25 至 55 岁（平均 29.5 岁）、单侧单个肾盂结石伴中至重度肾盂积水（PCS）的患者实施了该手术。结石大小为 20 至 30mm（平均 24mm）。所有患者均由经验丰富的泌尿科医师在超声引导下，通过针引导系统沿超声探头侧壁进行中盏穿刺和扩张。该手术的评估包括结石进入的成功率、术中或术后并发症的发生、无结石率以及辅助操作的需要。
所有病例均成功进入结石部位。两例术中出现 PCS 穿孔，经保守处理（双 J 支架置入 4 周）后痊愈。术后仅报告了五例发热的并发症，经抗生素治疗后缓解。术后第 2 天 32 例（94%）患者结石清除；两例患者仍有较大的结石残留（8mm 和 10mm），行体外冲击波碎石术，10 天内结石清除。
对于中至重度肾盂积水的单个肾盂结石，经验丰富的泌尿科医师可以安全地选择单独超声引导 PCNL 替代 X 线透视引导 PCNL。
