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Ultrasound-guided renal access and balloon dilation for PCNL in the prone position: results of a multicenter prospective observational study

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the safety and efficacy of ultrasound-guided renal access and tract dilation using balloon dilators, as well as to identify suitable patients for this technique.

Methods

Consecutive patients undergoing ultrasound-guided PCNL using balloon dilators between December 2019 and June 2020 in seven large medical centers from China were prospectively enrolled. Demographic and perioperative parameters of the patients were collected. Logistic regression analysis was used to analyze factors that would affect the success rate of tract establishment using ultrasound-guided renal access and balloon dilation.

Results

A total of 170 patients were included in this study, among whom, 91.18% of the (155/170) patients had a successful tract establishment under ultrasound guidance on the first attempt. The stone-free rate was 83.5% and postoperative complications occurred in 14 patients (8.23%). In univariate analysis, history of ipsilateral surgery (p = 0.026), and stone diameter (p = 0.01) were significantly associated with tract establishment failure, while a larger width of the target calyx (p = 0.016) and the presence of hydronephrosis (p = 0.001) were significantly associated with a successful tract establishment. In multivariate analysis, only hydronephrosis in target calyx (p = 0.027) was a favorable factor for successful tract establishment, and the history of ipsilateral renal surgery (p = 0.012) was the only independent risk factor for failure of tract establishment.

Conclusion

It was safe and effective to establish percutaneous renal access with balloon dilation under whole-process ultrasound monitoring during PCNL. Furthermore, patients with a hydronephrotic target calyx and without history of ipsilateral renal surgery were most suited to this technique.

Trial registration CHiCTR1800014448.

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Availability of data and materials

All data and materials supporting the findings of this work are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

Abbreviations

PCNL:

Percutaneous nephrolithotomy

BMI:

Body mass index

KUB:

PLAIN film of kidney ureter and bladder

CT:

Computed tomography

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Acknowledgements

None.

Funding

Supported by Beijing Natural Science Foundation (Grant No. 7222239).

Author information

Authors and Affiliations

  1. Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Dongxiaokou Town, Changping District, Beijing, China

    Boxing Su, Haifeng Song, Yubao Liu, Wenjie Bai, Shu Wang, Bo Xiao, Weiguo Hu & Jianxing Li

  2. Department of Urology, Fujian Provincial Hospital, Fuzhou, Fujian, China

    Zesong Yang

  3. Department of Urology, Affiliated Hospital of Hebei University, Baoding, China

    Wenzeng Yang & Feng An

  4. Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China

    Fangzhi Chen

  5. Department of Urology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China

    Peng He

  6. Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Gonghui Li & Haiyang Wu

  7. Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China

    Jinjian Yang & Songchao Li

Authors
  1. Boxing Su
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  2. Haifeng Song
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  3. Zesong Yang
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  4. Wenzeng Yang
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  5. Feng An
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  7. Peng He
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  8. Gonghui Li
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  9. Haiyang Wu
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  10. Jinjian Yang
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  11. Songchao Li
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  12. Yubao Liu
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  13. Wenjie Bai
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  14. Shu Wang
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  15. Bo Xiao
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  16. Weiguo Hu
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  17. Jianxing Li
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Contributions

BS and HS made substantial contributions to the manuscript draft and critical revised it. JL and WH made substantial contributions to the research design. All the authors made substantial contributions to the acquisition, analysis, and interpretation of data. All the authors approved the submission of this manuscript.

Corresponding author

Correspondence to Jianxing Li.

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The authors have no conflict of interest to declare.

Ethics approval

This study was approved by the Beijing Tsinghua Changgung Hospital Ethics Committee (17079–0310).

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Su, B., Song, H., Yang, Z. et al. Ultrasound-guided renal access and balloon dilation for PCNL in the prone position: results of a multicenter prospective observational study. World J Urol 40, 2339–2345 (2022). https://doi.org/10.1007/s00345-022-04072-6

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  • DOI: https://doi.org/10.1007/s00345-022-04072-6

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