Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy

Introduction: Dilation of the track can be achieved by multiple incremental flexible Amplatz type, Alken metal telescoping dilators, or balloon in Percutaneous Nephrolithotomy (PCNL). Balloon dilator is the most expensive method. Both of the incremental dilation techniques are more time consuming w...

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Autores principales:	Ganesh Bhakta Acharya, Anil Shrestha, Hari Bahadur KC, Robin Bahadur Basnet, Aravind Kumar Shah, Paras Mani Shrestha
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2017
Materias:	Amplaz dilator One-shot dilation Percutaneous nephrolithotomy (PCNL) Serial mental telescopic dilation Surgery RD1-811
Acceso en línea:	https://doaj.org/article/2e0fc40628d8407aa9d52678c699c483
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spelling	oai:doaj.org-article:2e0fc40628d8407aa9d52678c699c4832021-12-05T19:16:02ZRandomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy10.3126/jssn.v20i2.243761815-39842392-4772https://doaj.org/article/2e0fc40628d8407aa9d52678c699c4832017-12-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/24376https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Dilation of the track can be achieved by multiple incremental flexible Amplatz type, Alken metal telescoping dilators, or balloon in Percutaneous Nephrolithotomy (PCNL). Balloon dilator is the most expensive method. Both of the incremental dilation techniques are more time consuming with higher failure rates. Hence, a prospective randomized study was conducted to compare the safety and efficacy of “single shot” dilation of the nephrostomy tract by amplatz dilator with serial alken metallic telescopic dilation technique in PCNL. Methods: Of the 138 renal stone patients who underwent PCNL from January 2015 to December 2015, 100 patients were randomized into two groups. Serial tract dilation with alken metallic dilators was used in group A (n=50), and one shot dilation technique in Group B (n=50). The access tract dilation time, success rate, blood loss and complications were evaluated. Results: Both the groups were comparable in terms of mean age, location and size (largest diameter) of the stone (p>0.05). No difference was observed in the procedural success rate between groups A and B (96% v 94% respectively, p=0.64). Mean access time was similar in both groups (5.89+2.67 vs 4.98+2.0 mins, p=0.06). Complications between the groups were not significantly different. There were 6 patients with previous open stone surgery in both the groups. Previous open stone surgery did not impact procedural success rate, access time and complications in both groups. Conclusion: One-shot dilation technique is equally as effective, safe and well tolerated as metal telescopic dilation techniques even in patients with history of ipsilateral open stone surgery. Ganesh Bhakta AcharyaAnil ShresthaHari Bahadur KCRobin Bahadur BasnetAravind Kumar ShahParas Mani ShresthaSociety of Surgeons of NepalarticleAmplaz dilatorOne-shot dilationPercutaneous nephrolithotomy (PCNL)Serial mental telescopic dilationSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 20, Iss 2 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Amplaz dilator One-shot dilation Percutaneous nephrolithotomy (PCNL) Serial mental telescopic dilation Surgery RD1-811
spellingShingle	Amplaz dilator One-shot dilation Percutaneous nephrolithotomy (PCNL) Serial mental telescopic dilation Surgery RD1-811 Ganesh Bhakta Acharya Anil Shrestha Hari Bahadur KC Robin Bahadur Basnet Aravind Kumar Shah Paras Mani Shrestha Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
description	Introduction: Dilation of the track can be achieved by multiple incremental flexible Amplatz type, Alken metal telescoping dilators, or balloon in Percutaneous Nephrolithotomy (PCNL). Balloon dilator is the most expensive method. Both of the incremental dilation techniques are more time consuming with higher failure rates. Hence, a prospective randomized study was conducted to compare the safety and efficacy of “single shot” dilation of the nephrostomy tract by amplatz dilator with serial alken metallic telescopic dilation technique in PCNL. Methods: Of the 138 renal stone patients who underwent PCNL from January 2015 to December 2015, 100 patients were randomized into two groups. Serial tract dilation with alken metallic dilators was used in group A (n=50), and one shot dilation technique in Group B (n=50). The access tract dilation time, success rate, blood loss and complications were evaluated. Results: Both the groups were comparable in terms of mean age, location and size (largest diameter) of the stone (p>0.05). No difference was observed in the procedural success rate between groups A and B (96% v 94% respectively, p=0.64). Mean access time was similar in both groups (5.89+2.67 vs 4.98+2.0 mins, p=0.06). Complications between the groups were not significantly different. There were 6 patients with previous open stone surgery in both the groups. Previous open stone surgery did not impact procedural success rate, access time and complications in both groups. Conclusion: One-shot dilation technique is equally as effective, safe and well tolerated as metal telescopic dilation techniques even in patients with history of ipsilateral open stone surgery.
format	article
author	Ganesh Bhakta Acharya Anil Shrestha Hari Bahadur KC Robin Bahadur Basnet Aravind Kumar Shah Paras Mani Shrestha
author_facet	Ganesh Bhakta Acharya Anil Shrestha Hari Bahadur KC Robin Bahadur Basnet Aravind Kumar Shah Paras Mani Shrestha
author_sort	Ganesh Bhakta Acharya
title	Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
title_short	Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
title_full	Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
title_fullStr	Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
title_full_unstemmed	Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
title_sort	randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy
publisher	Society of Surgeons of Nepal
publishDate	2017
url	https://doaj.org/article/2e0fc40628d8407aa9d52678c699c483
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_version_	1718371053203357696

Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy

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