Computed tomography-ultrasonography (US) fusion for percutaneous nephrolithotomy access versus conventional US: A multicentre randomised trial.

In 30 seconds

This multicentre randomised trial evaluated the effectiveness of computed tomography-ultrasonography (CT-US) fusion navigation versus conventional US guidance in 180 adults undergoing percutaneous nephrolithotomy (PCNL) for renal stones >2 cm. The study found that CT-US fusion significantly improved first-pass success (93.3% vs 78.9%; P = 0.009) and resulted in a smaller 24-hour haemoglobin drop.

Key findings

• First-pass success was significantly higher with CT-US fusion at 93.3% compared to 78.9% with conventional US.
• The mean haemoglobin drop was smaller with CT-US fusion, at -3.45 g/L.
• Major bleeding complications occurred only in the conventional US group (6.7%).
• Procedural comfort was rated higher with CT-US fusion, median score 5 vs 3.

Why it matters

Accurate renal access is crucial in PCNL, and improved first-pass success can enhance patient outcomes and reduce complications. The findings suggest that CT-US fusion may be a superior method for guiding access in this procedure.