LAUSR

OBJECTIVE To compare if the outcomes of ultrasound-guided access percutaneous nephrolithotomy (UGA-PCNL) are similar to standard fluoroscopy-guided access percutaneous nephrolithotomy (FGA-PCNL). METHODS A review was developed using the MEDLINE and Scopus databases and following the PRISMA protocol. Studies comparing the USGA-PCNL and the FGA-PCNL were included. Case reports, editorials and letters, unpublished studies, posters and comments abstracts were excluded. RESULTS We found twelve published articles that compared USGA-PCNL and FGA-PCNL. These included 6 RCT, 3 CCT and 3 metanalysis. The overall results showed no difference in the success of percutaneous access, bleeding, blood transfusion, operative time, post-operative complications or hospital stay. CONCLUSION The reported data demonstrates that there is no significant differences between the fluoroscopic guided access PCNL and the ultrasonographic access PCNL. The choice of puncture depends on the surgeon expertise in a particular technique and the patient and stone characteristics. Both approaches are equally safe and effective in experienced hands. It is important to recall that the use of one technique does not exclude the use of the other, they can be sometimes be complementary to each other.