Comparison of One Shot Tract Dilatation to Metal Telescopic Dilatation in Percutaneous Nephrolithotomy and their Effect on Various Outcomes

Abstract

Background: Tract dilatation during percutaneous nephrolithotomy (PCNL) is a crucial step. Many methods to achieve it have been advocated; however superiority of anyone is not established. We have compared two popularly used methods namely metal telescopic dilatation (MTD) and one shot dilatation (OSD) in our study. Methods: Retrospective observational study included 40 adult patients of renal or upper ureteric stone, underwent PCNL. Group A utilized MTD, while OSD was used in group B. Demographic features, stone parameters, access establishment time, fluoroscopy time, stone free rate and complications were compared. Chi-square and Student T-test was used for analysis.Results: Group A and B had 21 and 19 cases respectively. Age, BMI, stone size, stone location, past surgery status, presence of hydronephrosis was similar in both groups. Tract dilatation fluoroscopy time was significantly shorter in group B (OSD) than A (MTD) (35.1±7.6 sec v/s 53.8±13.2 sec, p=.000). Access establishment time was also reduced in group B than A (289.7±89.7 sec v/s 405.1±133.3 sec, p=.003). Operation time, blood transfusion rate, hemoglobin drop and stone free rate was not significantly different among groups. Incidences of intraoperative and postoperative complications were also similar in both groups.Conclusion: Both methods are safe and effective for tract dilatation. OSD however is associated with lower radiation exposure and short access establishment time.