Safety And Efficiency Of Establishing Channels During Percutaneous Nephrolithotomy Under Ureteroscopic Vision

Objective:To evaluate the safety and efficiency of ureteroscopic vision method applying in establishing channel during percutaneous nephrolithotomy(PCNL).Methods:A retrospective study had been done including totally 325 percutaneous nephrolithotomy operations from January 2014 to June 2017 in the First Affiliated Hospital of Chongqing Medical University.All channels of PCNL were established under the guidance of ultrasound,of which 169 cases were operated using the ureteroscopic vision method to establish PCNL channel,while the other 156 cases did not.The sex,age,BMI,prior surgery and the S.T.O.N.E nephrolithometry score were compared before the operation between two groups.And channel establishment time,channel primary success rate,operation time,the amount of bleeding,and the channel related complication were compared between two groups.Results:The patients in both groups were successfully implemented PCNL.There were statistically significant differences in channel primary success rate,channel establishment time,and the amount of bleeding during operation between two groups(100%vs.94.9%,(10.5±2.4)min vs.(16.4±2.6)min,(11.15±5.99)g/L vs.(17.05±9.42)g/L;P<0.05).Complications related to channel establishment,including loss of channel,excessive puncture,vascular damage,massive hemorrhage,calyx neck injury were compared between two groups;those in experimental group was significantly lower than those in control group.The post-operation complications were classified and compared,according to Clavien-Dindo system,the complications above grade III were statistically significant lower in experimental group than in control group.Conclusion:The safety and efficiency of percutaneous nephrolithotomy can make improvement with ureteroscopic vision method.