Ultrasound-guided mini-percutaneous nephrolithotipsy performed on patients placed in lateral position: a prospective study

Abstract

Introduction: Minimal invasive intervention is preferred to open surgery in the treatment of kidney stone. Our goal is to assess the efficacy of ultrasound-guided mini-percutaneous nephrolithotripsy in lateral position for patients with renal stone disease. Methods: Prospective study on patients who underwent mini-percutaneous nephrolithotripsy in our department of Viet Duc hospital from 01/2021 to 12/2022. Spinal anesthesia was applied, patients were placed in the lateral position, using guidance of ultrasound, uretero-nephroscope, and nephrolithotripsy. The main outcomes were the rate of stone clearance and intraoperative or postoperative complications. Results: One thousand four hundred sixty-five patients, 1056 males (72.08%), mean age of 45.13±24.31 year-old. Pelvic stones accounted for 11.87%, lower caliceal stones 9.76%, and staghorn stones 19.41%. The stones occurred mostly in the left kidney (61.22%). Preoperative hydronephrosis cases detected by multi-slice computer tomography showed 24.09% at level 2 and 11.74% at level 3. Renal stone size: mean length: 3.1±0.76 cm, width: 1.82±0.56 cm. Mean operative time was 67.23±27.18 min (35–120 min). Intraoperative complications included 35 cases (2.38%) of hemorrhage not requiring blood transfusion. Postoperative complications rate was 2.66%. The mean length of hospital stay was 4.57±2.64 (2–8) days. Nephrostomy tube was removed after 2.87±1.43 days. Early stone-free rate was 82.98%. At 1-month follow-up, JJ stent removal was performed, and the stone-free rate achieved 96.87%. Conclusion: This method showed some benefits compared to traditional nephrolithotripsy. It is a useful, safe method and therefore highly recommended in the treatment of kidney stones.