Enrique Pulido-Contreras1, Miguel Angel Garcia-Padilla2, Javier Medrano-Sanchez2, Guadalupe Leon-Verdin3, Miguel Angel Primo-Rivera2, Roger L Sur4. 1. Urology Department, Unidad Medica de Alta Especialidad No. 1 Bajio, Instituto Mexicano del Seguro Social (IMSS), Lopez Mateos S/N., 37320, Leon, Guanajuato, Mexico. dr.enrique.pulido.uro@gmail.com. 2. Urology Department, Unidad Medica de Alta Especialidad No. 1 Bajio, Instituto Mexicano del Seguro Social (IMSS), Lopez Mateos S/N., 37320, Leon, Guanajuato, Mexico. 3. Delegación del Instituto Mexicano del Seguro Social (IMSS), Coordinación de Planeación y Enlace Institucional, Leon, Guanajuato, Mexico. 4. University of California-San Diego School of Medicine, San Diego, CA, USA.
Abstract
PURPOSE: The ultrasound-guided (US) puncture in percutaneous nephrolithotomy (PCNL) has demonstrated advantages over traditional fluoroscopy access. The aim of this study was to demonstrate the reduction of fluoroscopy time using this technique during PCNL as the surgeon gained experience. METHODS: Transversal study performed on 30 consecutive patients undergoing PCNL from March to November 2019. All punctures were performed with US guidance. The patients were divided into 2 groups of 15 each according to the chronological order of the intervention. Demographic data, preoperative parameters, puncture time, fluoroscopy time, stone-free rate and complications were analyzed. RESULTS: The time of fluoroscopy was considerably reduced as the experience in the number of cases increased, reducing from 83.09 ± 47.8 s in group 1 to 22.8 ± 10.3 s in group 2 (p < 0.01), the time required to perform the puncture was reduced of 108.1 ± 68.9 s in group 1, to 92.6 ± 94.7 s in group 2 (p < 0.67). Stone free rate of 83.3% was obtained globally. CONCLUSION: US percutaneous renal access is safe and reproducible technique; the main advantage is to reduce exposure to radiation without compromising clinical results and has a short learning curve for urologists with prior experience in PCNL.
PURPOSE: The ultrasound-guided (US) puncture in percutaneous nephrolithotomy (PCNL) has demonstrated advantages over traditional fluoroscopy access. The aim of this study was to demonstrate the reduction of fluoroscopy time using this technique during PCNL as the surgeon gained experience. METHODS: Transversal study performed on 30 consecutive patients undergoing PCNL from March to November 2019. All punctures were performed with US guidance. The patients were divided into 2 groups of 15 each according to the chronological order of the intervention. Demographic data, preoperative parameters, puncture time, fluoroscopy time, stone-free rate and complications were analyzed. RESULTS: The time of fluoroscopy was considerably reduced as the experience in the number of cases increased, reducing from 83.09 ± 47.8 s in group 1 to 22.8 ± 10.3 s in group 2 (p < 0.01), the time required to perform the puncture was reduced of 108.1 ± 68.9 s in group 1, to 92.6 ± 94.7 s in group 2 (p < 0.67). Stone free rate of 83.3% was obtained globally. CONCLUSION: US percutaneous renal access is safe and reproducible technique; the main advantage is to reduce exposure to radiation without compromising clinical results and has a short learning curve for urologists with prior experience in PCNL.
Authors: M S Linet; D M Freedman; A K Mohan; M M Doody; E Ron; K Mabuchi; B H Alexander; A Sigurdson; M Hauptmann Journal: Occup Environ Med Date: 2005-12 Impact factor: 4.402
Authors: Sero Andonian; Cesare M Scoffone; Michael K Louie; Andreas J Gross; Magnus Grabe; Francisco P J Daels; Hemendra N Shah; Jean J M C H de la Rosette Journal: J Endourol Date: 2012-10-17 Impact factor: 2.942