One-shot dilation in modified supine position for percutaneous nephrolithotomy: experience from over 300 cases

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrolithotomy

Background:

• Percutaneous nephrolithotomy (PCNL) is a standard procedure for kidney stone removal.
• Optimizing PCNL techniques is crucial for improving patient outcomes and reducing complications.

Purpose of the Study:

• To assess the feasibility, safety, and efficacy of one-shot dilation (OSD) in a modified supine position for PCNL.
• To evaluate OSD as a potentially advantageous alternative to standard dilation methods.

Main Methods:

• A retrospective analysis of 320 PCNL procedures in 291 patients performed between October 2008 and July 2011.
• Inclusion criteria allowed patients with complex stone burdens, renal anomalies, or prior surgical history.
• Data collected included operative times, radiation exposure, complication rates, and success of tract dilation.

Main Results:

• Successful targeted calix entry was achieved in 97.81% of cases.
• Mean access time was 2.1 minutes with tract dilation fluoroscopy time of 25 seconds.
• Major complications were low, including transfusion in 1.25% and one nephrectomy (0.3%); two deaths (0.62%) occurred post-surgery.

Conclusions:

• One-shot dilation in a modified supine position for PCNL is feasible, safe, and effective.
• This technique offers reduced radiation exposure and shorter operative times.
• OSD is a cost-effective and easily learned alternative, particularly beneficial in resource-limited settings.