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Comparison of safety and efficacy of one shot dilation vs. gradual dilation technique in supine percutaneous nephrolithotomy

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Abstract

Purpose

To compare the efficacy and safety of gradual dilation (GD) and one-shot dilation (OSD) techniques in patients who underwent supine percutaneous nephrolithotomy (PCNL).

Methods

The data of 176 patients who underwent supine PCNL were reviewed. Eighty-seven patients who underwent OSD were defined as group 1, and 89 patients who underwent GD were defined as group 2. Both surgical techniques were compared with each other in terms of various parameters. Then, regression analysis of factors predicting stone-free status and complications in patients who underwent supine PNL were performed. Then, regression analysis of factors predicting success rate and complications in patients who underwent supine PNL were performed.

Results

No statistical difference was found in terms of stone-free rate, Clavien–Dindo complication grade and operation time. No statistical difference was found in terms of success rate, Clavien–Dindo complication grade and operation time. However, the fluoroscopy time was found to be significantly shorter in group 1 (p < 0.001). In the analysis of factors predicting stone-free status, the presence of calyceal stones, increased stone size and number were associated with a decrease in stone-free rate. In the analysis of factors predicting success, the presence of calyceal stones, increased stone size and number were associated with a decrease in success rate. Increased fluoroscopy and operation time, increased complication rates were found to be significantly associated with residual stone. Analysis of factors predicting complications found a higher complication rate in patients with low BMI and severe hydronephrosis. Increased complication was associated with increased time to nephrostomy removal and hospital stay, decrease in stone-free rate, decrease in Hb and increase in Cre value at the postoperative 24th hour.

Conclusion

When comparing OSD and GD in patients undergoing supine PCNL, both techniques have similar stone-free and complication rates. When comparing OSD and GD in patients undergoing supine PCNL, both techniques have similar success and complication rates. Compared to GD, the OSD technique can be preferred primarily due to its shorter fluoroscopy time.

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References

  1. Skolarikos A Neisius A, Petřík A, Somani B,Thomas K, Gambaro (2022) EAU guidelines on urolithiasis. In: EAU Guidelines Office, ed. European Association of Urology. EAU Guidelines Office:1–114. https://uroweb.org/guideline/urolithiasis/

  2. Fernstrom I, Johansson B (1976) Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 10(3):257–259. https://doi.org/10.1080/21681805.1976.11882084

    Article  CAS  PubMed  Google Scholar 

  3. Valdivia JG, Santamaría EL, Rodríguez SV (1987) Percutaneous nephrolithectomy: simplified technic (preliminary report). Arch Esp Urol 40(3):177–180

    Google Scholar 

  4. Kumar P, Bach C, Kachrilas S, Papatsoris AG, Buchholz N, Masood J (2012) Supine percutaneous nephrolithotomy (PCNL): ’In vogue’but in which position? BJU Int 110:2. https://doi.org/10.1111/j.1464-410X.2012.11188.x

    Article  Google Scholar 

  5. Keller Etienne X, Coninck Vincent DE, Proietti S et al (2021) R E V I E W prone versus supine percutaneous nephrolithotomy: a systematic review and meta-analysis of current literature. Miner Urol Nephrol 73(1):50–58. https://doi.org/10.23736/S2724

    Article  CAS  Google Scholar 

  6. Ganpule AP, Shah DH, Desai MR (2014) Postpercutaneous nephrolithotomy bleeding: aetiology and management. Curr Opin Urol 24(2):189–194. https://doi.org/10.1097/MOU.0000000000000025

    Article  PubMed  Google Scholar 

  7. Yamaguchi A, Skolarikos A, Buchholz NPN et al (2011) 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 25(6):933–939. https://doi.org/10.1089/END.2010.0606

    Article  PubMed  Google Scholar 

  8. Peng PX, Lai SC, Ding ZS et al (2019) One-shot dilation versus serial dilation technique for access in percutaneous nephrolithotomy: a systematic review and meta-analysis. BMJ Open 9(4):25871. https://doi.org/10.1136/BMJOPEN-2018-025871

    Article  Google Scholar 

  9. Tefekli A, Karadag MA, Tepeler K et al (2008) Classification of percutaneous nephrolithotomy complications using the modified clavien grading system: looking for a standard. Eur Urol 53(1):184–190. https://doi.org/10.1016/J.EURURO.2007.06.049

    Article  PubMed  Google Scholar 

  10. Valdivia JG, Scarpa RM, Duvdevani M et al (2011) Supine versus prone position during percutaneous nephrolithotomy: a report from the clinical research office of the endourological society percutaneous nephrolithotomy global study. J Endourol 25(10):1619–1625. https://doi.org/10.1089/END.2011.0110

    Article  PubMed  Google Scholar 

  11. Davidoff R, Bellman GC (1997) Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. J Urol 157(4):1229–1231. https://doi.org/10.1016/S0022-5347(01)64931-0

    Article  CAS  PubMed  Google Scholar 

  12. Jing X, Ying S, Xiaoping Z, Yifei X, Li Wencheng MD (2019) Chinese one-shot dilation versus sequential fascial dilation for percutaneous nephrolithotomy: a feasibility study and comparison. Urol J 16(1):21–26. https://doi.org/10.22037/UJ.V16I1.4610

    Article  Google Scholar 

  13. Peng PX, Lai SC, Seery S et al (2020) Original research: Balloon versus Amplatz for tract dilation in fluoroscopically guided percutaneous nephrolithotomy: a systematic review and meta-analysis. BMJ Open 10(7):35943. https://doi.org/10.1136/BMJOPEN-2019-035943

    Article  Google Scholar 

  14. Proietti S, Rodríguez-Socarrás ME, Eisner B et al (2019) Supine percutaneous nephrolithotomy: tips and tricks. Transl Androl Urol 8(Suppl 4):S381. https://doi.org/10.21037/TAU.2019.07.09

    Article  PubMed  PubMed Central  Google Scholar 

  15. Aydemir H (2020) Two different renal dilatation techniques in percutaneous nephrolithotomy: one-shot dilation vs sequential dilation. South Clin Istanb Eur 2:2. https://doi.org/10.14744/SCIE.2019.29292

    Article  Google Scholar 

  16. Hajiha M, Baldwin DD (2019) New technologies to aid in percutaneous access. Urol Clin North Am 46(2):225–243. https://doi.org/10.1016/J.UCL.2019.01.001

    Article  PubMed  Google Scholar 

  17. Cao D, Liu L, Liu H, Wei Q (2013) A comparison among four tract dilation methods of percutaneous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis 41(6):523–530. https://doi.org/10.1007/S00240-013-0598-Z

    Article  Google Scholar 

  18. Li Y, Yang L, Xu P et al (2013) One-shot versus gradual dilation technique for tract creation in percutaneous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis 41(5):443–448. https://doi.org/10.1007/S00240-013-0583-6

    Article  PubMed  Google Scholar 

  19. Wu Y, Xun Y, Lu Y, Hu H, Qin B, Wang S (2020) Effectiveness and safety of four tract dilation methods of percutaneous nephrolithotomy: a meta-analysis. Exp Ther Med 19(4):2661. https://doi.org/10.3892/ETM.2020.8486

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Frattini A, Barbieri A, Salsi P et al (2001) One shot: a novel method to dilate the nephrostomy access for percutaneous lithotripsy. J Endourol 15(9):919–923. https://doi.org/10.1089/089277901753284143

    Article  CAS  PubMed  Google Scholar 

  21. el Harrech Y, Abakka N, el Anzaoui J, Goundale O, Touiti D (2014) One-shot dilation in modified supine position for percutaneous nephrolithotomy: experience from over 300 cases title. Urol J 11(3):1575–1582

    PubMed  Google Scholar 

  22. Mohyelden K, Abdel-Rassoul MA, Dogha MM, Kadry A, Mostafa A (2022) One-shot dilatation vs metal dilator during percutaneous nephrolithotomy in flank-free supine position: a randomized controlled study. J Endourol 36:6. https://doi.org/10.1089/END.2021.0378

    Article  Google Scholar 

  23. Curry D, Srinivasan R, Kucheria R et al (2017) Supine percutaneous nephrolithotomy in the Galdako-modified valdivia position: a high-volume single center experience. J Endourol 31(10):1001–1006. https://doi.org/10.1089/END.2017.0064

    Article  PubMed  Google Scholar 

  24. Falahatkar R, Shahraki T, Falahatkar S, Esmaeili S, Mashouf P (2021) Evaluating outcomes of complete supine percutaneous nephrolithotomy for staghorn vs multiple non-staghorn renal stones: a 10-year study. World J Urol 39(8):3071–3077. https://doi.org/10.1007/S00345-020-03563-8

    Article  CAS  PubMed  Google Scholar 

  25. Labate G, Modi P, Timoney A et al (2011) The percutaneous nephrolithotomy global study: classification of complications. J Endourol 25(8):1275–1280. https://doi.org/10.1089/END.2011.0067

    Article  PubMed  Google Scholar 

  26. El-Nahas AR, Eraky I, Shokeir AA et al (2012) Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone. Urology 79(6):1236–1241. https://doi.org/10.1016/J.UROLOGY.2012.01.026

    Article  PubMed  Google Scholar 

  27. El-Assmy AM, Shokeir AA, El-Nahas AR et al (2007) Outcome of percutaneous nephrolithotomy: effect of body mass index. Eur Urol 52(1):199–205. https://doi.org/10.1016/J.EURURO.2006.11.049

    Article  PubMed  Google Scholar 

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Acknowledgements

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The author(s) received no financial support for the research, authorship and/or publication of this article.

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Authors and Affiliations

  1. Department of Urology, Health Sciences University Adana City Training and Research Hospital, Adana, Turkey

    Mert Hamza Özbilen

  2. Department of Urology, Beyhekim Training and Research Hospital, Konya, Turkey

    Batuhan Ergani

  3. Department of Urology, Health Sciences University Izmir Bozyaka Health Practice and Research Center, Izmir, Turkey

    Taha Çetin

  4. Department of Urology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey

    Mehmet Yiğit Yalçın

  5. Department of Urology, İstanbul Medeniyet University, Istanbul, Turkey

    Mehmet Çağlar Çakıcı

  6. Department of Urology, Bezmi Alem Vakıf University, Istanbul, Turkey

    Yusuf Özlem İlbey

  7. Department of Urology, Health Sciences University Izmir Tepecik Health Practice and Research Center, Izmir, Turkey

    Çağdaş Bildirici, Erkin Karaca, Tufan Süelözgen & Gökhan Koç

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  1. Mert Hamza Özbilen
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Contributions

MHÖ contributed to protocol/project development and manuscript writing/editing. BE was involved in data analysis. TÇ contributed to data analysis. MYY was involved in data analysis. ÇB contributed to data collection or management. EK was involved in data collection or management. MÇÇ contributed to manuscript writing/editing. TS was involved in Protocol/project development and manuscript writing/editing. GK contributed to Protocol/project development. YÖİ was involved in Protocol/project development.

Corresponding author

Correspondence to Mert Hamza Özbilen.

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Conflicts of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Research involving human participants and/or animals and ethical approval

The study protocol was approved by the ethics committee of the University of Health Sciences Izmir Tepecik Health Practice and Research Center (Decision No: 2021/11-20). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent form was obtained from all patients.

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Özbilen, M.H., Ergani, B., Çetin, T. et al. Comparison of safety and efficacy of one shot dilation vs. gradual dilation technique in supine percutaneous nephrolithotomy. World J Urol 41, 1659–1666 (2023). https://doi.org/10.1007/s00345-023-04393-0

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  • DOI: https://doi.org/10.1007/s00345-023-04393-0

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