Moderated Poster Session
Introduction & Objective :
To describe our initial experience using a micro-optical system through a specific puncture needle (4.2Fr) to achieve1-step percutaneous nephrolithotomy (needle-perc), and to investigate its efficacy and safety under total ultrasonography in patients aged
Methods : Needle-perc was performed using the 4.2Fr needle sheath with a 3-way connector allowing irrigation, and passage of a 0.6 mm optical fiber and a 200 um holmium:YAG laser fiber. The puncture site selection and renal access was achieved under total ultrasound guidance. We retrospectively reviewed 9 patients (10 renal units) aged <3 years with renal calculi < 2.0 cm between April 2016 and January 2018 in our units. The mean age of the patients was 24 (range 6–36) months and the mean maximum stone diameter was 13.9 (range 8–20) mm.
Results : In all cases, visualization of the punctured kidney calyces was successful. The mean time to establish access was 0.8 (range 0.5–2) min, the mean operative time was 19.8 (range 15–35) min, the mean decrease in hemoglobin concentration was 5.1 (3–10) g/L, and the stone-free rate at 1 month was 93.5 %. The mean postoperative hospital stay was 2.5 (range 2–4) days. Post-procedure complications included fever (>38.5 °C) in three patients. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed.
Ultrasound-guided needle-perc is safe and efficacious for small renal calculous in patients aged <3 years,without major complications or radiation exposure
Beijing Tsinghua Changgung Hospital
Boxing Su, MD. PhD. Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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