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Published on: July 19, 2018
Modified amplatz sheath with suction versus standard sheath in percutaneous nephrolithotomy for treating large renal
Abdallah Fathi1, Mohammed Ibrahem1, Shabib Mohammed1
1Urology Department, Faculty of Medicine, Benha University, Benha, 13511, Qalyubiya Governorate, Egypt.
Purpose:
To evaluate the efficacy and safety of using a modified amplatz as an access sheath in percutaneous nephrolithotomy (PCNL) compared to the standard Amplatz sheath for the treatment of renal stones larger than 2 cm.
Methods:
This prospective randomized study was conducted on 240 patients with renal stones larger than 2 cm who underwent PCNL. Patients were randomized into two equal groups: Group I (standard Amplatz sheath) and Group II (modified Amplatz sheath). Outcomes measured included operative time, stone-free rate (SFR), complications, and hospital stay.
Results:
The modified Amplatz sheath group had a significantly shorter mean operative time compared to the standard sheath group (56 ± 12 vs. 83 ± 17 min, respectively; P < 0.001). The SFR was higher in the modified sheath group (90.8% vs. 80%; P = 0.017). Postoperative complications, such as fever (4.2% vs. 10.8%) and pain (13.3% vs. 20.8%), were significantly lower in the modified sheath group (P = 0.036). The modified sheath group also had a shorter hospital stay, with 93.3% discharged within two days compared to 85% in the standard group (P = 0.038). Multivariate analysis indicated that the use of the modified sheath reduced the risk of residual stones by 91% (OR = 0.086, 95% CI = 0.027-0.280, P < 0.001).
Conclusions:
The use of a modified Amplatz sheath in PCNL significantly reduces operative time, increases the SFR, and decreases postoperative complications compared to the standard Amplatz sheath.
