A Comparison of Metal Telescopic Dilators and Amplatz Dilators for Nephrostomy Tract Dilation in Percutaneous Nephrolithotomy

Özok, Uğur; Sağnak, Levent; Şentürk, Aykut Buğra; Karakoyunlu, Nihat; Topaloğlu, Hikmet; Ersoy, Hamit

doi:10.1089/end.2011.0291

Cited by 34 publications

(34 citation statements)

References 25 publications

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“…Other parameters such as total operative time, fluoroscopy time, and tract formation time were not different between the two groups. Similarly, the tract dilation failure rate was comparable between the two groups, which is consistent with other study outcomes [14]. In our cohort, in the Amplatz group there was insignificantly fewer failures.…”

Section: Discussionsupporting

confidence: 92%

Percutaneous Nephrolithotomy with Amplatz and Alken Dilators: An Eight-Year Single Tertiary Care Centre Experience

et al. 2016

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BackgroundPercutaneous nephrolithotomy (PNL) is the standard procedure for patients with renal stones over 2 cm in diameter. We analyzed complications after this procedure focusing on two different methods of tract dilation.Material/MethodsBetween August 2008 and April 2016 222 percutaneous nephrolithotomies were performed in a total of 208 patients. The Group I (n=123) comprised patients where Alken dilatators were used, while Group II (n=99) comprised patients where Amplatz dilators were used. Efficacy was examined based on ultrasound and x-ray examination one month after the procedure. Complications were recorded using Clavien Dindo classification.ResultsEfficacy was 85.3% and 86.8% in group I and II, respectively (p=0.77). Grade I complications were present in 14.6% and 3%, grade II were present in 9.7% and 8%, grade IIIa were present in 2.4% and 2%, grade IIIb were present in 1.6% and 2%, grade IVa were present in 1.6% and 7%, grade IVb were present in 3.2% and 1% in Group I and Group II, respectively. These differences were statistically significant (p=0.03).ConclusionsEfficacy was comparable between Alken dilator and Amplatz dilator groups. In group I, there were more postoperative fevers >38.5 °C and a higher rate of urosepsis. On the other hand, in group II we observed more pleural injuries. All differences resulted from the type of access to the kidney (inter/infracostal), punctured calyx, and utilization (or not) of access sheath rather than type of dilators itself.

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Section: Discussionsupporting

confidence: 92%

Percutaneous Nephrolithotomy with Amplatz and Alken Dilators: An Eight-Year Single Tertiary Care Centre Experience

et al. 2016

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“…In the prone position under fluoroscopy guidance, the most appropriate calyx was determined and a glide wire was introduced with a diamond-tipped needle and dilatation up to 30F was achieved with an amplatz dilator [8]. Then, the sheath was placed, and by entering with a Storz nephroscope, the stones were broken with a pneumatic lithotriptor and removed with forceps.…”

Section: Surgical Methodsmentioning

confidence: 99%

A comparison of standard PCNL and staged retrograde FURS in pelvis stones over 2 cm in diameter: a prospective randomized study

et al. 2015

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The aim of the study was to compare percutaneous nephrolithotomy (PCNL) and staged retrograde flexible ureteroscopy (FURS) methods used in the treatment of kidney stones of 2 cm or more in diameter. The study comprised a total of 60 patients with a diagnosis of kidney pelvic stones more than 2 cm in diameter, for whom surgery was planned between January 2013 and January 2014. The patients were randomly allocated to two groups as staged retrograde FURS (Group A) and PCNL (Group B). Comparison of the groups was made with respect to operating time, number of procedures, total treatment time, length of hospital stay, stone-free rates and complications according to the Clavien-Dindo classification. In Group A, the total operating time of multiple sessions was 114.46 min. In Group B, a single session of PCNL was applied to all patients and the mean operating time was 86.8 min (p = 0.014). Mean total treatment time was 2.01 weeks in Group A and 1 week in Group B (p < 0.01). The mean total hospitalization time was 3.66 days in Group A and 3.13 days in Group B (p = 0.037). At the end of the sessions, clinically insignificant residual fragments were observed in ten patients of Group A and one patient of Group B (p = 0.03). No statistically significant difference was determined between the groups in terms of stone-free rates or complications. Although current technology with FURS is effective on large kidney stones, it has no superiority to PCNL due to the need for multiple sessions and long treatment time.

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“…The stones were fractionated using a pneumatic lithotripter. Following confirmation of complete clearing of stones both endoscopically and fluoroscopically, reentry pigtail catheter (Mikrovasive) was placed antegradely [5]. …”

Section: Methodsmentioning

confidence: 99%

A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

Topaloğlu

Karakoyunlu

Sarı

et al. 2014

BioMed Research International

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Purpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones. Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed. Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.; P = 0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.; P = 0.039). Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.

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A Comparison of Metal Telescopic Dilators and Amplatz Dilators for Nephrostomy Tract Dilation in Percutaneous Nephrolithotomy

Abstract: The Alken dilation technique produces similar results to the Amplatz dilators in terms of efficiency, safety, and total operative time. Notwithstanding, it is more cost-effective in comparison.

Cited by 34 publications

References 25 publications

Percutaneous Nephrolithotomy with Amplatz and Alken Dilators: An Eight-Year Single Tertiary Care Centre Experience

Percutaneous Nephrolithotomy with Amplatz and Alken Dilators: An Eight-Year Single Tertiary Care Centre Experience

A comparison of standard PCNL and staged retrograde FURS in pelvis stones over 2 cm in diameter: a prospective randomized study

A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

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