Efficacy and safety of ultrasound-guided percutaneous nephrolithotomy for kidney calculi patients with ankylosing spondylitis: a retrospective single center analysis

Background: To investigate the efficacy and safety of ultrasound-guided percutaneous nephrolithotomy (PCNL) in kidney calculi patients with ankylosing spondylitis (AS). Methods: The data of 22 renal stone patients (25 kidney units) with AS who underwent PCNL in our institute from January 2008 to December 2019 were analyzed retrospectively. General information of these patients, intraoperative and postoperative data were recorded. The primary parameter for efficacy was initial and final stone free rates (SFR) with X-ray kidney, ureter, and bladder (KUB) were performed 1st or 2nd day and 1 month after surgery. Preoperative and postoperative laboratory results, surgical procedures and the occurrence of postoperative complications were used to identify the safety PCNL intervention. Results: Most PCNLs were performed with general anesthesia (76%) and prone position (64%). The initial SFR and final SFR were 80% (20 kidney units) and 88% (22 kidney units) respectively. Haemoglobin decreased after PCNL occurred in 22 patients (88.0%) and the mean postoperative hemoglobin drop was 1.32 +/- 0.76 g/L (range, 0.10-3.10 g/L), with one patient received blood transfusion. One patient developed postoperative fever (T > 38.5.). No other complications such as colon injury, extravasation of urine, perinephric infection and urosepsis occurred. Conclusions: The result of ultrasound-guided PCNL for kidney stone patients with AS is satisfactory with high SFR and security. Operative position, anesthesia method and damage caused by drugs used in the treatment of AS should be considered to achieve better result.