A comparative study between one step dilatation and serial dilatation technique in percutaneous nephrolithotomy

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Percutaneous nephrolithotomy (PCNL) is a primary treatment for large kidney stones (>2 cm), known for lower morbidity and faster recovery.
• Nephrostomy access creation is a critical step in PCNL, achievable via single-step or multi-step serial dilatation.

Purpose of the Study:

• To compare the efficacy of single-step versus serial dilatation techniques in PCNL.
• To evaluate differences in access time, fluoroscopy time, blood transfusion rates, hospital stay, and complications.

Main Methods:

• A prospective study involving 100 patients undergoing PCNL.
• 50 patients received single-step dilatation, and 50 received serial dilatation.
• Analysis included demographic data, access/fluoroscopy times, hematuria, hospital stay, and complications.

Main Results:

• Patient demographics and stone characteristics were comparable between groups.
• Single-step dilatation showed significantly reduced mean access tract dilatation time and fluoroscopy time.
• Blood transfusion rates and post-operative complication rates were not significantly different.

Conclusions:

• Both single-step and serial dilatation are safe and effective for PCNL access.
• Single-step dilatation provides advantages of decreased renal access time and reduced radiation exposure.
• There were no statistically significant differences in blood loss or hospital stay between the two methods.