Abstract：Objective： To investigate the clinical efficacy of ultrasound-guided peritoneal transperitoneal nephroscopic lithotripsy for the treatment of kidney graft stone. Methods： The clinical data of 10 patients with kidney graft calculi treated between July 2018 and September 2022 were retrospectively reviewed.There were 7 males and 3 females with ages ranging from 41-76（54.30 ± 12.13） years.Right kidney graft calculi were present in 6 cases and left kidney graft calculi in 4.There were 3 single pelvic calculi, 1 single ureteral junction calculi, and 6 multiple pelvic calculi, all of which were located in the renal pelvis.The maximum calculi diameter was （2.08 ± 0.51） cm.Calculi CT values were （1364.60±194.11）Hu. Results： All 10 patients underwent transperitoneal percutaneous nephroscopic lithotripsy guided by ultrasound under general anesthesia.Under ultrasound guidance in combination with preoperative CTU, graft puncture sites were determined and appropriate size puncture channels were established.Three Fr 20, five Fr18 and two Fr16 channels were constructed, and calculi fragmentation was performed with holium laser.Calculi-free status, operative time, preoperative postoperative parameters, postoperative complications were observed and recorded.All 10 patients had successful primary surgery and calculi-free procedure.Surgical duration was （59.80±6.46） min.Postoperative hospital stay was（5.60 ± 0.70 ）d.There were no sepsis, persistent pain, intraoperative blood transfusion, intestinal duct and mesenteric vascular injury.One patient showed elevated creatinine after operation, which returned to normal after 3 days.After 3 days of surgery, neither color ultrasound nor 1-month repeat computed tomography showed calculi residue, and two J tubes were successfully removed.During the 3-month to 1-year follow-up period,no calculi recurrence occurred and renal function was normal. Conclusion： Ultrasound-guided peritoneal transperitoneal nephroscopic lithotripsy for the treatment of kidney graft calculi is safe and effective.
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