Comparison of Safety and Efficacy of One Shot Dilation Vs. Gradual Dilation Technique in Supine Percutaneous Nephrolithotomy

Overview

Journal World J Urol

Specialty Urology

Date 2023 Apr 11

PMID 37039907

Authors

Mert Hamza Ozbilen

Batuhan Ergani

Taha Cetin

Mehmet Yigit Yalcin

Cagdas Bildirici

Erkin Karaca

Mehmet Caglar Cakici

Tufan Suelozgen

Gokhan Koc

Yusuf Ozlem Ilbey

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the efficacy and safety of gradual dilation (GD) and one-shot dilation (OSD) techniques in patients who underwent supine percutaneous nephrolithotomy (PCNL).

Methods: The data of 176 patients who underwent supine PCNL were reviewed. Eighty-seven patients who underwent OSD were defined as group 1, and 89 patients who underwent GD were defined as group 2. Both surgical techniques were compared with each other in terms of various parameters. Then, regression analysis of factors predicting stone-free status and complications in patients who underwent supine PNL were performed. Then, regression analysis of factors predicting success rate and complications in patients who underwent supine PNL were performed.

Results: No statistical difference was found in terms of stone-free rate, Clavien-Dindo complication grade and operation time. No statistical difference was found in terms of success rate, Clavien-Dindo complication grade and operation time. However, the fluoroscopy time was found to be significantly shorter in group 1 (p < 0.001). In the analysis of factors predicting stone-free status, the presence of calyceal stones, increased stone size and number were associated with a decrease in stone-free rate. In the analysis of factors predicting success, the presence of calyceal stones, increased stone size and number were associated with a decrease in success rate. Increased fluoroscopy and operation time, increased complication rates were found to be significantly associated with residual stone. Analysis of factors predicting complications found a higher complication rate in patients with low BMI and severe hydronephrosis. Increased complication was associated with increased time to nephrostomy removal and hospital stay, decrease in stone-free rate, decrease in Hb and increase in Cre value at the postoperative 24th hour.

Conclusion: When comparing OSD and GD in patients undergoing supine PCNL, both techniques have similar stone-free and complication rates. When comparing OSD and GD in patients undergoing supine PCNL, both techniques have similar success and complication rates. Compared to GD, the OSD technique can be preferred primarily due to its shorter fluoroscopy time.

Citing Articles

Effects of hydronephrosis on the surgical outcomes of fluoroscopically guided supine percutaneous nephrolithotomy.

Yucel C, Ozbilen M, Bildirici C, Dumanli E, Akbay E, Yoldas M Int Urol Nephrol. 2024; 56(8):2555-2563.

PMID: 38431533 DOI: 10.1007/s11255-024-03969-y.

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