Does salvage endoscopically guided tract dilatation increase complications during sonography-guided percutaneous...

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Percutaneous nephrolithotomy (PCNL) relies on tract dilation for renal access.
• Tract dilation can fail due to short advancement of dilators.

Purpose of the Study:

• To evaluate the safety and efficacy of endoscopic tract dilatation as a salvage technique for PCNL.
• To compare complications and outcomes of salvage endoscopic dilation versus standard one-shot dilation.

Main Methods:

• Sonography-guided PCNL was performed on 108 patients.
• One-shot Amplatz dilation was attempted; salvage endoscopic tract dilation with bi-prong forceps was used for short-advancement cases.
• Outcomes including operative time, stone-free rate, and complications were compared between successful one-shot Amplatz (SA) and salvage endoscopic (SE) groups.

Main Results:

• Short-advancement occurred in 58.3% of patients, with salvage technique success in 95.2%.
• Operative times (SE: 21.1 min vs. SA: 22.7 min) and stone-free rates (SE: 81.0% vs. SA: 73%) were comparable (p > 0.2).
• No significant differences in transfusion rates or postoperative complications were observed between the groups.

Conclusions:

• Salvage endoscopic tract dilation is a viable and safe option when one-shot Amplatz dilation is unsuccessful during PCNL.
• This technique does not lead to increased complications or inferior clinical outcomes compared to standard one-shot dilation.