Therapeutic Effect Of Ultrasound-guided Standard Channel Percutaneous Nephrolithotomy In The Treatment Of Renal Stones In Horseshoe Kidney

Objective: To observe and analyze the clinical effect of ultrasound-guided standard channel percutaneous nephrolithotomy(PCNL)for the treatment of horseshoe kidney stones.Methods: Retrospective analysis and of clinical date of 20 patients who were diagnosed of horseshoe kidney stones and treated by ultrasound-guided standard channel percutaneous nephroscope pneumatic ballistics combined with ultrasonic lithotripsy in the First Affiliated Hospital of China Medical University from February 2012 to October2017.Including 16 cases of male patients and 4 cases of female patient,whose age were23 years to 65 years.The average was(41.7±11.06)years.12 cases were occurred in the left side and 8 cases occurred in the right side.The stones sized(2.55±0.69)cm in diameter and average CT value was(1084.40±304.01)HU.Among these cases,multiple calculi were in 8,staghom calculi and cast stone each had one case,and remanining 10 cases were renal pelvis calculi.During these cases,there were 15 patients combined with hydronephrosis,2 cases with renal cysts,and 1 case with renal pelvis ureteral malformation.Results: All patients had a single puncture channel,one of which established a double channel and the other was a single channel.This group of 20 patients were successfully complished by PCNL.The stone clearance was 80.0%(16/20),in 4 cases of residual stone patients,one case received a second-session PCNL to remove the residual calculi and 3cases through drugs and extracorporeal shock wave lithotripsy.Of all tracts,11 were establlished through middle calyx(55.0%,11/20),2 through uper and middle calyx(10.0%,2/20),4 through middle and lower calyx(20.0%.4/20),1 through uper calyx(5.0%,1/20),and 2 through uper calyx(10.0%,2/20).The average operation time was(57.20±20.07)min.The HGB drop was(13.65±7.65)g/l.The hospital stay was(6.93±2.12)days.The average inpatient cost was(31418.78±6671.30)yuan.There were 3patients occurred fever postoperative,the highest temperature of 38.6℃,and returned to normal after treatment of adjusting antibiotic.1 cases had blood transfusion therapy.There was no serious complications such as pneumothorax,pleural effusion,abdominal viscera injury.Conclusion: Ultrasound-guided standard channel percutaneous nephrolithotomy is safe and effective for the treatment of patients with horseshoe kidney stones.It is worthy of being recommended in clinical practice.