Effect of the ultrasound-guided transperitoneal percutaneous nephrolithotomy in treatment of renal calculi in pelvic ectopic kidney / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the safety and efficacy of ultrasound-guided transperitoneal PCNL for treatment of renal calculi in pelvic ectopic kidney.Methods The clinical data of 4 cases of pelvic ectopic kidney treated in our hospital from June 2016 to August 2017 were retrospectively analyzed.The patient's age ranged from 30 to 67 years with an average of 47.25 years.There were two male and two female patients.2 cases suffered with left pelvic ectopic kidney stones.One case had right pelvic horseshoe ectopic kidney stones and one case had spinal deformity left pelvic ectopic kidney stones.Multiple stones were found in 2 cases.The mainly stones located in the renal pelvis in one case.Multiple stones in the lower calyx was found in another case.The remaining 2 cases had single stones in the renal pelvis.Stone size was 3.4 cm × 2.1 cm,3.0cm×2.1 cm,2.8 cm×2.4 cm and 2.1 cm×1.9 cm respectively.And 1 case with renal calculi in left pelvic ectopic kidney had a history of open surgerv 11 years ago because of the same situation with pelvic ectopic kidney calculi.In this study,all operation was performed under general anesthesia.The ultrasound-guided percutaneous nephrolithotomy combined with preoperative CTU and intraoperative color Doppler ultrasound was used to find the target renal calyx or renal pelvis.And a certain pressure was applied to the abdominal wall to make the intestinal canal deviate from the surface of the pelvic ectopic kidney as much as possible.Under ultrasound real-time detection,it was punctured into the target renal calyx or renal pelvis to find and break stones.And F6 double J tube and F18 nephrostomy tube were left.Operative and post-operative related details (stone free,bleeding,abdominal infection) were reviewed.Results Stone free rate were 100％ (4/4).The time of operation and hospital stay were 62,59,55,51 min and 6,6,5,5 days,respectively.None had significant intraoperative and postoperative complications,including haemorrhage,injury of mesenteric vessels,abdominal infection and hydrops.No one left residual stones during 1 month and 3 nonths of follow-up.Conclusions The ultrasound-guided transperitoneal PCNL is a safe and effective procedure for the treatment of patients with renal calculi in pelvic ectopic kidney.