Ultrasound-guided steel needle cross projection in percutaneous nephroscopy localization / 中国内镜杂志

ABSTRACT

Objective To evaluate the application value of ultrasound-guided steel needle cross projection in percutaneous nephroscopy localization for clinical treatment. Methods From July 2015 to July 2017, we selected 307 cases of percutaneous nephrolithotomy with ultrasonic stereoscopic precision positioning, stones are antipyroid stones, renal calculi multiple kidney stones, ESWL treatment failure, isolated kidney stones, renal pelvis and ureteral junction (UPJ) obstruction with stones, open stone surgery recurrence, upper ureteral stones and so on. Refer to preoperative CT and KUB+IVP to determine the puncture angle and the puncture of the calyx. Then, in the ultrasonic stereo precise positioning to select the first mark line and the second mark line, two-line intersection for the final puncture point, this point with the first mark point connection with the vertical axis of the kidney.Finally, at the end of the puncture point in the ultrasonic stereo precise probe under the guidance of the probe to adjust the target angle of the calyx puncture. Results Of the 307 patients, 281 were 1 ~ 2 successful punctures, 21 were 3 ~ 5 times. The total success rate was 98.4% (302/307). 5 cases of small incision were separated to the kidney weeks under the guidance of the fingers.1 case of bleeding after 2 days (by selective renal artery embolization to stop bleeding).The net rate of calculi was 95.8% (294/307) and 13 residual stones were less than 0.5 cm. Conclusions The application of ultrasonic stereoscopic accurate positioning in percutaneous nephroscopy is safe and effective, and the localization method is refined and easy to be promoted.