A Retrospective Comparison of the Balloon Dilator and the Telescopic Metal Dilator for Tract Dilatation during Percutaneous Nephrolithotomy
Narutsama Pimpanit¹, Charoen Leenanupunth¹, Yada Phengsalae¹, Premsant Sangkum¹, Wisoot Kongchareonsombat¹, Kittinut Kijvikai¹, Chinnakhet Ketsuwan¹
Affiliation : ¹ Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for the management of large renal calculi. Nephrostomy tract dilatation is an essential step in PCNL. However, the types of dilatations used depend on the surgeon’s preference.
Objective: To compare the effectiveness and safety of the balloon dilator (BD) against the telescopic metal dilator.
Materials and Methods: The present study involved 238 patients that underwent PCNL between January 2011 and February 2020. They were divided into two groups based on the adopted tract dilatation technique. The balloon dilatation group included 69 cases, and the telescopic metal dilator group included 169 cases. They were analyzed in terms of demographics and perioperative outcomes.
Results: The two PCNL groups were similar in age, stone burden, and stone density. There was no statistically significant differences in the stone-free status at 59.4% versus 56.8% (p=0.711), tract dilatation failure rates at 1.5% versus 0.6% (p=0.511), estimated blood loss at 200 mL versus 200 mL (p=0.311), blood transfusion rates at 11.6% versus 8.9% (p=0.520), and total operation time at 120 minutes versus 120 minutes (p=0.573) for the balloon dilatation group and the telescopic metal dilator group, respectively. The duration of the nephrostomy placement in the balloon dilatation group was significant longer than the telescopic metal dilator group at 3 days versus 4 days (p=0.005).
Conclusion: Both BD and telescopic metal dilator possess equivalent effectiveness and safety for PCNL.
Received 11 May 2021 | Revised 12 November 2021 | Accepted 12 November 2021
DOI: 10.35755/jmedassocthai.2022.07.12943
Keywords : Percutaneous nephrolithotomy; Renal calculus; Balloon dilator; Telescopic metal dilator
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