Comparison of balloon dilation tract real-time monitored by ultrasound combined with endoscopic versus unitary ultrasound guided in percutaneous nephrolithotomy: a retrospective study

Abstract Background: The establishment of tract is very important in percutaneous nephrolithotomy. At present, balloon dilatation is widely used, but ultrasound or fluoroscopy guided balloon dilatation tract can not achieve real-time monitoring of the whole process, which easily leads to failure of tract establishment. we use ultrasound combined with endoscopic technology to realize the whole process monitoring of tract establishment. The purpose is to evaluate the safety and effectiveness of the technology.Methods: Patients who underwent PCNL with only using the balloon dilator from January 2019 to April 2021 in the Second Affiliated Hospital of Anhui Medical University were retrospectively reviewed. They were divided into ultrasound combined with endoscopic guidance group and ultrasound-guided group. The demographic and renal stone characteristics, intraoperative and postoperative data were analyzed.Results: A total of 72 patients were included in the study, including 35 patients in the ultrasound combined with endoscopic guidance group and 37 patients in the ultrasound-guided group. There was no difference in demographic and stone characteristics between the two groups.There were no significant differences between the two groups in surgical time, number of tract, hemoglobin decreased, stone free rate, ancillary treatment and postoperative complication rate. The tract establishment time of the ultrasound combined with endoscopic guidance group was significantly less than that of the ultrasound-guided group (P<0.05). There was no tract establishment failure in the ultrasound combined with endoscopic guidance group, while there were 7 cases in the ultrasound-guided group.Conclusions: Ultrasound combined with endoscopic guidance can monitor the establishment of working tract of PCNL in real time. Compared with unitary ultrasonic guidance, the time of tract establishment can be shortened and the failure of tract establishment can be avoided.