2017, Number 6
Approach to percutaneous nephrolithotomy. Comparison of the procedure in a one-shot versus the sequential with metal dilatators
Sedano-Portillo I, Ochoa-León G, Fuentes-Orozco C, Irusteta-Jiménez L, Michel-Espinoza LR, Salazar-Parra M, Cuesta-Márquez L, González-Ojeda A
Language: Spanish
References: 14
Page: 677-682
PDF size: 189.32 Kb.
ABSTRACT
Introduction: Percutaneous nephrolithotomy is an efficient approach for treatment of different types of kidney stones. Various types of access techniques have been described like sequential dilatation and one-shot procedure. Objective: To determine the differences in time of exposure to X-rays and hemoglobin levels between techniques. Methods: Controlled clinical trial. Patients older than 18 years with complex/uncomplicated kidney stones, without urine infection were included. They were assigned randomly to one of the two techniques. Response variables were determined before and 24 h after procedures. Results: 59 patients were included: 30 underwent one-shot procedure (study-group) and 29 sequential dilatation (control-group). Baseline characteristics were similar. Study group had a lower postoperative hemoglobin decline than control group (0.81 vs. 2.03 g/dl, respectively; p ‹ 0.001); X-ray exposure time (69.6 vs. 100.62 s; p ‹ 0.001) and postoperative creatinine serum levels (0.93 ± 0.29 vs. 1.13 ± 0.4 mg/dl; p = 0.039). No significant differences in postoperative morbidity were found. Conclusion: One-shot technique demonstrated better results compared to sequential dilatation.REFERENCES
Yamaguchi A, Skolarikos A, Buchholz NP, et al. Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Study Group. Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5,537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol. 2011;25:933-9.