One-shot versus metal telescopic dilation technique for tract creation in percutaneous nephrolithotomy: comparison of safety and efficacy.

PURPOSE: The aim of this study was to assess the feasibility and morbidity of single-step acute dilation, named "one-shot" technique, including a single dilation of the nephrostomy tract with a 28F or 30F Amplatz dilator compared with metal telescopic dilation technique.

PATIENTS AND

METHODS

Two hundred fourteen patients who underwent percutaneous nephrolithotomy (PNL) for stone disease from September 2005 to October 2007 were included in the study, and they were randomly divided into two groups according to the type of tract dilation technique: in group 1 (112 patients), Alken telescopic dilators were used; in group 2 (102 patients), one-shot technique was used. Access tract dilation time, X-ray exposure time, success rate, and blood loss and other complications were evaluated.

RESULTS

One-shot technique was compared using Alken telescopic dilators without an increase in morbidity and with significant reduction in X-ray exposure (p = 0.003). There was no significant difference in the procedural success rate between groups 1 and 2 (100% v 96.07%, respectively) (p = 0.765). There was no any significant difference in complications. Access time was similar in both groups (p = 0.14).

CONCLUSION

One-shot dilation was proved to be safe and effective like metal telescopic dilation even in patients with a history of ipsilateral open renal surgery. In this procedure, X-ray exposure is lower.