Ultrasound guidance for renal access in percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure. The current study compared the safety and effectiveness of ultrasound-guided PCNL (US-PCNL) for renal stone therapy versus fluoroscopy-guided PCNL (FL-PCNL) in prone position. Successful puncture was attained in all cases in both groups. Unlike fluoroscopy, US guidance reduced the time needed for achieving renal puncture that was (22.45 ± 6.95 s) compared to fluoroscopy that was (68.28 ± 56.76 s) (P value < 0.001). The mean duration of access that was reported in our study was (3.92 ± 0.72 min) in the US-PCNL group and (4.03 ± 0.77 min) in the FL-PCNL group (P value 0.460). There was no significant difference in the total operative time between both groups in our study as the mean operative time in the US-PCNL group was (61.47 ± 6.07 min) and (65.86 ± 20.86 min) in the FL-PCNL group with a (P value of 0.349). Stone-free rate was nearly similar in both groups (P value 0.336). Three cases in our study in the FL-PCNL group had bleeding that required blood transfusion post-operative; mean Hb change was 0.23 g/dL and 0.55 g/dL in US-PCNL and FL-PCNL groups, respectively, which is clinically irrelevant despite statistical significance (P value 0.007). Mean fluoroscopy time was (6.38 ± 3.84) minutes in FL-PCNL group. Ultrasound guidance is a reliable tool in the hands of experienced urologists in performing PCNL with less or even zero radiation.

中文翻译：

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超声引导下经皮肾镜取石术与传统C形臂引导下经皮肾镜取石术：一项前瞻性随机比较研究

超声引导经皮肾镜取石术（PCNL）肾通路是一种安全、有效且低成本的手术。目前的研究比较了超声引导 PCNL (US-PCNL) 与俯卧位透视引导 PCNL (FL-PCNL) 治疗肾结石的安全性和有效性。两组均实现成功穿刺。与透视不同，超声引导缩短了实现肾穿刺所需的时间（22.45 ± 6.95 秒），而透视则为（68.28 ± 56.76 秒）（P 值 < 0.001）。我们的研究中报告的 US-PCNL 组的平均访问持续时间为（3.92 ± 0.72 分钟），FL-PCNL 组的平均访问持续时间为（4.03 ± 0.77 分钟）（P 值 0.460）。在我们的研究中，两组之间的总手术时间没有显着差异，US-PCNL 组的平均手术时间为（61.47 ± 6.07 分钟），FL-PCNL 组的平均手术时间为（65.86 ± 20.86 分钟）， P 值为 0.349）。两组的无结石率几乎相似（P 值 0.336）。我们研究中的 FL-PCNL 组中有 3 例出现术后出血，需要输血；US-PCNL 和 FL-PCNL 组的平均 Hb 变化分别为 0.23 g/dL 和 0.55 g/dL，尽管有统计学意义，但在临床上无关（P 值 0.007）。FL-PCNL组平均透视时间为（6.38±3.84）分钟。对于经验丰富的泌尿科医师来说，超声引导是一种可靠的工具，可以在较少甚至零辐射的情况下进行 PCNL。