Single-step renal dilatation in percutaneous nephrolithotomy: A prospective randomised study

Abstract

ObjectiveTo perform an economical single-step renal dilatation (RD) during percutaneous nephrolithotomy (PCNL), using directly a 30-F Amplatz dilator over the central Alken dilator, in a trial to reduce the operative duration and radiation exposure during RD while avoiding an exchange of dilators that might increase the risk of blood loss.Patients and methodsIn a prospective randomised study including 49 patients divided into two groups, the first had RD before PCNL using the standard metallic telescopic dilators (Alken), and the second had RD using the 30-F Amplatz dilator over the central Alken dilator. The operative duration, with X-ray exposure, was calculated. The procedure outcome in terms of complications, stone-free rates and hospital stay was evaluated statistically.ResultsThe tract was dilated correctly in all cases. The operative duration and X-ray exposure was shorter in patients undergoing single-step RD (P < 0.05). There were perioperative complications, according to the Clavien grading system, in 17 (34%) patients but there was no statistically significant difference between the groups. The stone-free rates were comparable in both groups.ConclusionA single-step RD during PCNL is feasible, with a shorter operative duration and X-ray exposure. The outcomes were comparable with those of a standard metallic telescopic RD.

Two Different Renal Dilatation Techniques in Percutaneous Nephrolithotomy: One-Shot Dilation vs. Sequential Dilation

“…The need for fluoroscopic control for the insertion and checking of each dilator during the SD procedure increases the amount of radiation-exposed. [14] In a prospective study with 49 patients, Nour et al [17] compared the standard metallic telescopic dilatation (Alken) and the OD procedure with Amplatz dilators. In this study, the operation time was shorter, and the total radiation exposure was lower in the OD group.…”

Percutaneous nephrolithotomy tract dilatation techniques comparison (Balloon vs. Amplatz): Our Experience in Middle East.

“…No versions have been observed regarding X-ray exposure between the 2 techniques on account that no ultrasound guidance became used and each technique were depending on continuous radiology exposure all through the dilatation of the PCNL tract. Also, tract dilatation by means of amplatz in our analysis because of the retrospective observe aspect turned into completed by way of serial dilatation, no longer via unmarried-shot dilatation method which provides shorter operative time and less radiation exposure in keeping with maximum of the literature 11,12,13 .…”

Updates in endourological management of urolithiasis

“…In an effort to reduce the radiation exposure, one‐step dilatation using a semirigid dilator was introduced . It was shown to be feasible, safe and well tolerated, with outcomes comparable with standard Alken dilators and less radiation exposure for intraoperative staff …”

“…62 It was shown to be feasible, safe and well tolerated, with outcomes comparable with standard Alken dilators and less radiation exposure for intraoperative staff. 63,64 To conclude for the dilatation techniques, comparative studies showed that none of the aforementioned dilatation methods were significantly better than another, and the choice depends on the clinical situation, stone condition and surgeon's preference. 65,66 Size of tract Currently, there are at least two nomenclature for PCNL tract size, which might lead to confusion (Table 2).…”