Doppler ultrasound and X-ray-guided percutaneous nephrolithotomy with one-step balloon dilation for complex renal stones.

Objectives: To assess the safety and efficacy of combining Doppler ultrasound with X-ray-guided percutaneous nephrolithotomy (PCNL) with one-step balloon dilation for management of complex renal stones. Material and Methods: We retrospectively analyzed 85 renal stone patients who underwent 89 PCNLs from January 2011 to May 2012. Doppler ultrasound with X-ray-guided PCNL with one-step balloon dilation was finished on the Fluoroscopic Table (Siemens, Berlin, Germany) with the patient under general anesthesia. Results: The study included 85 patients (49 male and 36 female) with a mean age of 42.5 +/- 16.4 years. All patients underwent 89 PCNLs (4 patients had bilateral stones). The mean operative time was 72.8 min (range: 35-140). The average fluoroscopic screening time was 5.55 +/- 1.81 s (range: 4-12). Successful access to the collecting system was 98.9% (88/89). Although most of the cases (85/89) were managed satisfactorily by a single tract, a second tract was used in 4 cases. No severe complications occurred. The stone-free rate of PCNL monotherapy was 77.5% (69/89). At 3 months, the stone-free rate increased to 89.9% (80/89) after shock wave lithotripsy. Conclusions: PCNL with one-step balloon dilation for the management of complex renal stones under the guidance of combining Doppler ultrasound with X-ray is safe and effective because of its high stone-free rate and low operative time. Copyright (C) 2013 S. Karger AG, Basel