Abstract
To determine the clinical value of the real-time-ultrasound-guided minimally invasive percutaneous nephrolithotomy (m-PCNL) technique in the supine position, 92 patients suffering from renal or upper ureteral stones were treated by m-PCNL with a nephroscope/ureteroscope in the supine position. The ipsilateral flanks of the patients with different body sizes were elevated with a 1,000 or 3,000-ml water bag. Under cystoscopy, a ureteral catheter was inserted into the kidney. Normal saline was infused into the kidney via the ureteral catheter to dilate the entire urinary system. Under the guidance of real-time ultrasound, the needle was inserted into the urinary system to dilate the tract and establish the 16F mini-tract for percutaneous nephrolithotomy. All 92 (100%) m-PCNL procedures were successfully performed in the supine position. Primary stone clearance was achieved in 64 cases (69.6%). Residual stones occurred in 28 cases (30.4%). M-PCNL was performed for a second time in 16 cases to clear the residual stones. In 4 cases, stones remained after the second m-PCNL. Two of them were treated further by extracorporeal shockwave lithotripsy (ESWL). The total stone clearance rate of m-PCNL was 82.6%. Only one case required blood transfusion. No other serious complications occurred. The supine position is a favorable position for the patients, the surgeons and the anesthesiologists during the m-PCNL procedure. Real-time ultrasound is a valuable technique for guiding of the m-PCNL.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Valdivia-Uria JG, Valer J, Villarroya S et al (1995) Why is percutaneous nephroscopy still performed with patient prone? J Endourol 4:269–272
Valdivia-Uria JG, Gerhold J, Lopez JA et al (1999) Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol 160:1975–1978
Gao X, Zhou T, Xiao CL et al (2003) Developing renal tract for percutaneous nephrostolithotomy solely under the guide of B-Ultrasound (Report of 102 cases). J Clin Urol 18:10–12
Gofrit ON, Shapiro A, Donchin Y (2002) Lateral decubitus position for percutaneous nephrolithotripsy in the morbidly obese or kyphotic patient. J Endourol 16(6):383–386
Shoma AM, Eraky I, El-Kenawy MR et al (2002) Percutaneous nephrolithotomy in the supine position: technical aspects and functional outcome compared with the prone technique. Urology 60(3):388–392
Li X, Zeng GH, Yuan J et al (2004) Treatment of upper urinary calculus with the PCNL technique (Experience of 20 years). J Peking Univ Health Sci 36(2):124–126
Netto NR, Lemos GC, Fiuza JL (1988) Colon perforation following percutaneous nephrolithotomy. Urology 32(3):223–224
Vallancien G, Capdeville R, Veillon B et al (1985) Colonic perforation during percutaneous nephrolithotomy. J Urol 134(6):1185–1187
Hopper KD, Maj MC, Sherman JL et al (1987) The retrorenal colon in the supine and prone patient. Radiology 162:443–446
Boon JM, Shinners B, Meiring JH (2001) Variations of the position of the colon as applied to percutaneous nephrostomy. Surg Radiol Anat 23(6):421–425
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhou, X., Gao, X., Wen, J. et al. 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 (2008). https://doi.org/10.1007/s00240-008-0134-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00240-008-0134-8