Doppler ultrasound and X-ray-guided percutaneous nephrolithotomy with one-step balloon dilation for complex renal stones.

OBJECTIVES

To assess the safety and efficacy of combining Doppler ultrasound with X-ray-guided percutaneous nephrolithotomy (PCNL) with one-step balloon dilation for management of complex renal stones.

MATERIAL AND

METHODS

We retrospectively analyzed 85 renal stone patients who underwent 89 PCNLs from January 2011 to May 2012. Doppler ultrasound with X-ray-guided PCNL with one-step balloon dilation was finished on the Fluoroscopic Table (Siemens, Berlin, Germany) with the patient under general anesthesia.

RESULTS

The study included 85 patients (49 male and 36 female) with a mean age of 42.5 ± 16.4 years. All patients underwent 89 PCNLs (4 patients had bilateral stones). The mean operative time was 72.8 min (range: 35-140). The average fluoroscopic screening time was 5.55 ± 1.81 s (range: 4-12). Successful access to the collecting system was 98.9% (88/89). Although most of the cases (85/89) were managed satisfactorily by a single tract, a second tract was used in 4 cases. No severe complications occurred. The stone-free rate of PCNL monotherapy was 77.5% (69/89). At 3 months, the stone-free rate increased to 89.9% (80/89) after shock wave lithotripsy.

CONCLUSIONS

PCNL with one-step balloon dilation for the management of complex renal stones under the guidance of combining Doppler ultrasound with X-ray is safe and effective because of its high stone-free rate and low operative time.