title: Solo Sonographically Guided PCNL under Spinal Anesthesia: Defining Predictors of Success.
abstract: Aim. Sonography has been brought in percutaneous nephrolithotripsy (PCNL) as an adjunct to or substitute for X-ray to restrict radiation exposure. This study was designed to investigate the possible predictors for the success of the solo sonographically guided PCNL. Methods. 148 consecutive cases were prospectively enrolled. All steps of PCNL were performed solely with sonography guidance under spinal anesthesia. Residual stones were evaluated the day after surgery using sonography and plain radiography. Results. The mean age was 46 ± 15 years; 40% of kidneys had hydronephrosis. The mean stone burden was 504 ± 350 mm(2). The mean duration of surgery was 43 ± 21 minutes. The early stone-free rate was 92% in inferior or middle calyceal stones, 89.5% in single pelvic stones, 81.5% in partial staghorn stones, and 61.9% in staghorn stones. The mean residual stone size was 13 ± 8 mm. Logistic regression showed that a lower age and a larger stone burden significantly predicted positive residual stones. Fifteen percent of patients presented with grade I or II and six percent showed grade III complication based on Clavien classification. There was no cases of organ injury or death. Conclusion. Solo ultrasonographically guided PCNL under spinal anesthesia is feasible with an acceptable stone-free rate and complication rate.
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Akbar
authors.initials: A
authors.lastname: Nouralizadeh
authors.affiliation: Department of Urology, Shahid Bahonar Hospital, Kerman University of Medical Sciences (KMU), Kerman 7613747181, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Pakmanesh
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aayanifard
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Soltani
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Tabibi
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Sharifiaghdas
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Seyed Amir Mohsen
authors.initials: SA
authors.lastname: Ziaee
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Shakhssalim
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Valipour
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Narouie
authors.affiliation: Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Radfar