The clinical efficacy in decreasing hemorrhagic complication by B-ultrasound combined with color Doppler ultrasound guidance in percutaneous nephrolithotomy / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the clinical significance of using B-ultrasound combined with color Doppler ultrasonography guidance in percutaneous nephrolithotomy ( PCNL) to decease the incidence of hemorrhagic complication.Methods A total of 323 patients with renal or urethral stones who had undergone PCNL were retrospectively categorized into 2 groups.Group 1 (147 patients) underwent PCNL with single B-ultrasound guidance while group 2 (176 patients) underwent PCNL with combined B-ultrasound and color Doppler ultrasound guidance. The clinical characteristics and complications, especially hemorrhagic complications in the two groups were recorded and compared.Results There were no statistical significances in age [ ( 53.2 ±12.9 ) years vs.( 54.7 ±9.1 ) years ] , hight [ ( 165.1 ±8.5 ) cm vs.( 164.6 ± 6.9) cm], weight[ (66.1 ±19.2) kg vs.(64.9 ±16.3) kg], stone burden [(680.5 ±56.4) mm2 vs. (654.0 ±76.9) mm2], operative time[(117.6 ±55.1) min vs.(121.4 ±54.3) min], stone-free rate (90.7%vs.91.3%), or postoperative hospital stay [(4.9 ±2.2)d vs.( 4.7 ±1.7 )d] between the two groups.In the B-ultrasound combined color Doppler ultrasound guidance group, the rate of blood transfusion (1.1%vs.3.4%) and super-selective embolization (0 vs.3.4%) was significantly lower than that of the single B-ultrasound guidance group.Besides, the incidents of renal arteriovenous fistula (0 vs.2.0%), pseudoaneurysm (0 vs.2.0%), and perirenal hematoma (0 vs.1.4%) were significantly lower in the B-ultrasound combined color Doppler ultrasound guidance group than that of the single B-ultrasound guidance group.Conclusion Using B-ultrasound combined color Doppler ultrasound guidance during PCNL resulted in the real-time detection and avoidance of the renal blood vessels during puncture and decreased the incidence of hemorrhagic complications.