The Clinical Application of Puncture Frame in Establishing Ultrasound Guided Percutaneous Nephrolithotomy Access

Purpose: To investigate the clinical efficacy and safety of ultrasound-guided percutaneous nephrolithotomy (PCNL) assisted by a puncture frame. Materials and Methods: Clinical data of 106 patients with nephrolithiasis who underwent ultrasound-guided percutaneous nephrolithotomy from October 2016 to December 2017 in our hospital were analyzed retrospectively. The channels were established by the assistance of the puncture frame. Results: The mean puncture time was 35 ± 18 seconds, the puncture was performed 1.3 ± 0.9 times on average. The puncture was successfully performed at first attempt in 73 cases. The mean operation time was 67.3 ± 39.2 min, and the mean intraoperative blood loss was 48 ± 22 mL. The stones were located on the left in 50 (47.2%) cases, and on the right in 56 (52.8%) cases. Channels were established through the upper, middle and lower calyces of the kidney in 78 (73.6%), 20 (18.9%), and 8 (7.5%) cases, respectively. The puncture sites were located on the upper and lower of 12th rib in 81 (76.4%) and 25 (23.6%) cases. Intraoperative and postoperative blood transfusion was given in four cases. Pleural injury occurred in two cases, and hydropneumothorax occurred in one case in whom closed thoracic drainage was performed. The stone free rate after a single surgery was 87.7% (93/106). Conclusion: Establishing a percutaneous nephrolithotomy access tract under ultrasound guidance using the puncture frame is an efficacious and safe approach.