A Comparative Study of Clinical Value of Single B-Mode Ultrasound Guidance and B-Mode Combined With Color Doppler Ultrasound Guidance in Mini-invasive Percutaneous Nephrolithotomy to Decrease Hemorrhagic Complications

OBJECTIVES To compare the clinical value of single B-mode ultrasonography and B-mode combined with color Doppler ultrasonography in the guidance of mini-invasive percutaneous nephrolithotomy (m-PCNL) to decrease the incidence of hemorrhagic complications. METHODS A total of 297 patients with renal stones who had undergone m-PCNL were retrospectively categorized into 2 groups. Group 1 (187 patients) underwent m-PCNL with single B-mode ultrasound guidance and group 2 (110 patients) underwent m-PCNL with combined B-mode and color Doppler ultrasound guidance. The clinical characteristics of the patients, intraoperative and postoperative characteristics, complications, especially hemorrhagic complications, and blood transfusion rate were recorded and compared. RESULTS No statistically significant differences in age, height, weight, stone burden, operative time, stone-free rate, or length of postoperative hospital stay were found between the 2 groups. In group 2, a statistically significant decrease in the transfusion rate was found compared with group 1 (P < .05). In group 1, 5 patients (2.6%) required a blood transfusion, 2 (1.1%) developed a renal arteriovenous fistula and required embolotherapy, 2 (1.1%) developed hemorrhage and required embolotherapy after surgery, 16 (8.6%) developed capillary hemorrhage during surgery but had no hemorrhage postoperatively. However, no serious hemorrhagic complications were found in group 2. Only 3 patients (2.7%) developed capillary hemorrhage during surgery, and no hemorrhage occurred postoperatively. CONCLUSIONS Using combined B-mode and color Doppler ultrasound guidance during in m-PCNL resulted in the real-time detection and avoidance of the renal blood vessels during puncture and decreased the incidence of hemorrhagic complications, especially in the patients with a solitary and compensative kidney. UROLOGY 76: 815-820, 2010. (C) 2010 Elsevier Inc.