Abstract:Objective: To compare the safety and feasibility of the establishment of percutaneous nephrolithotomy (PCNL) tracts with sequential fascial dilatation vs. balloon dilatation. Methods: 217 cases of PCNL from January 2012 to June 2014 were randomly divided into two groups: group A (n=125) and group B (n=92). The PCNL tract was established by sequential fascial dilatation and balloon dilatation in group A and group B respectively. The stone clearance rate, tract establishing time, operation time, blood loss and hospital expenses were recorded and compared. Results: All of the 217 cases were operated successfully. Balloon dilatation was significantly superior to sequential fascial dilatation in shortening the tract establishing time (F=515.402, P=0.000) and reducing intraoperative blood loss (F=39.551, P=0.000), but gained a higher hospital expenses. Conclusions: Establishing the PCNL tract with balloon dilatation is more safe than sequential fascial dilatation, and the feasibility unchanged.
王博,高吉,张茁,韩宇平,谷欣权. 连续筋膜扩张法和球囊扩张法建立经皮肾镜通道在经皮肾镜碎石术中的对比研究[J]. 微创泌尿外科杂志, 2015, 4(4): 235-238.
Wang Bo, Gao Ji, Zhang Zhuo, Han Yuping, Gu Xinquan. Comparative study of establishment of percutaneous nephrolithotomy tract with sequential fascial dilatation vs. balloon dilatation. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(4): 235-238.
[1]Lopes L, Sangam K, Alken P, et al. The clinical research office of the endourological society percutaneous nephrolithotomy global study: tract dilation comparisons in 5537 patients. J Endourol, 2011, 25(5): 755-762. [2]Davidoff R, Bellman GC. Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. J Urol, 1997,157(4): 1229-1231. [3]Heggagi MA, Karsza A, Szule EJR. Use of different types of dilator systems in the prevention of complications of percutaneous renal surgery. Acta Chir Hung, 1991,32(4): 365-369. [4]Kukreja R, DesaiM, Pate S, et al. Factors affecting blood loss during nephrolithotomy: prospective study. J Endourol, 2004,18(8): 715-722. [5]Turna B, Nazli O, Demiryoguran S, et al. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology, 2010,82(4): 32-33. [6]Safak M, Gogus C, Soygur T, et al. Nephrostomy tract dilation using a balloon dilator in percutaneous renal surgery: experience with 95 cases and comparison with the fascial dilator system. Urol Int, 2003,71(4): 382-384. [7]Benway BM, Nakada SY. Balloon dilation of nephrostomy tracts. J Endouro, 2008,22(9): 1875-1876. [8]Kumar V, Ahlawat R, Banjeree GK, et al. Percutaneous ureterolitholapaxy: the best bettoclear large bulk impacted upper ureteral calculi. Arch Esp Urol, 1996,49(3): 86-91. [9]Yamaguchi A, Skolarikos A, Buchholz NP, et al. Operating times and bleeding complications in percutaneous nephrolithotomy: A comparison of tract dilation methods in 5537 patients in the clinical research office of the endourological society percutaneous nephrolithotomy global study. J Endourol, 2011,25(6): 933-993. [10]Tomaszewski JJ, Smaldone MC, Schuster T, et al. Factors affecting blood loss during percutaneous nephrolithotomy using balloon dilation in a large contemporary series. J Endourol, 2010,24(2): 207-211. [11]Joel AB, Rubenstein JN, Hsieh MH, et al. Failed percutaneous balloon dilation for renal access: incidence and risk factors. Urology, 2005,66(1): 29-32. [12]Williams SK, Bird VG, Mauri G, et al. Borrowing from interventional radiology: novel technique to dilate scarred nephrostomy tract. Urology, 2008,72(5): 1156-1158. [13]Ozok HU, Sagnak L, Senturk AB, et al. A comparison of metal telescopic dilators and Amplatz dilators for nephrostomy tract dilation in percutaneous nephrolithotomy. J Endourol, 2012,26(6): 630-634. [14]Kurtulus FO, Fazlioglu A, Tandogdu Z, et al. Percutaneous nephrolithotomy: primary patients versus patients with history of open renal surgery. J Endourol, 2008, 22(12): 2671-2675. [15]De Lisa A, Caddeo G. PCNL: tips and tricks in targeting, puncture and dilation. Arch Ital Urol Androl, 2010,82(1): 32-33. [16]Gnen M, Istanbulluoglu OM, Cicek T, et al. Balloon dilatation versus Amplatz dilatation for nephrostomy tract dilatation. J Endourol, 2008,22(5): 901-904. [17]高新,周铁,萧翠兰,等.单用B超引导建立经皮肾穿刺通道行经皮肾镜取石(附102例报告).临床泌尿外科杂志,2003,18(1): 10-12. [18]田建国,濮建明,李建国.超声联合X线定位球囊扩张通道经皮肾镜治疗肾结石.中华临床医师杂志(电子版),2013,7(15): 179-180.