Ultrasonography-Guided Standard Percutaneous Nephrolithotomy for Calculi within Horseshoe Kidneys / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of standard percutaneous nephrolithotomy(PCNL)guided by ultrasonography for calculi within horseshoe kidneys.Methods From September 2005 to January 2008,44 patients with calculi within horseshoe kidneys(51 sides)underwent ultrasonography-guided F24-tract PCNL in our hospital.Among the cases,single calculus was found in 24 kidneys,multiple calculi were detected in 18,and staghorn calculi in 9.The stones sized(24.4?5.8)mm in length.Results All the operations were completed in one session,single tract was established in 49 kidneys,while double tracts were used in the other 2;31 of the tracts were made through the upper calyx,20 via the middle calyx,and 2 through the lower calyx.The mean operation time was(48.4?11.9)min.The stone-free rate after one-session operation was 88.2%(45/51),3 cases received a second-session PCNL to remove the residual calculi.After the operation,the hemoglobin decreased by(11.3?3.7)% in the patients,none of them received blood transfusion.Postoperative rate of surgery-related infection was 5.9%(3/51).No pleural or abdominal injury occurred.44 patients were followed up for 11.4 months,during the period one of the 3 patients who received the second-session surgery achieved stone-free.The rate of recurrence at 6 months was 2.0%(1/51),and 6.5% at 1 year(3/46).Conclusions Ultrasonography-guided standard PCNL is effective and safe for calculi within horseshoe kidneys.