Abstract
Access to the renal calyx is a challenging and crucial step for a successfulpercutaneousnephrolithotomy (PCNL). There are different methods of access tract dilatation, and there is no consensus on which method is the best. We conducteda comparative retrospective study on the safety and efficacy of the Alken metallicdilator and Amplatzdilator for renal access inPCNL. We retrospectively reviewed the medical records of80 patients who underwent PCNL between March 2023 and February 2024, and they were divided into two groups.Group A (n=42) comprised patients where Alken dilators were used, while group B (n=38) comprised patients where Amplatz dilators were used. Safety parameters, that is, perioperative bleeding, blood transfusion, access time, postoperative fever, and urosepsis, were compared between the groups. Efficacy in terms of successful renal access and stone clearance was also compared. The mean access time (mins) was longer in group B than group A (8.1 vs. 7.3, p=0.012).The intraoperative bleeding was more in group B (15.7% vs. 4.7%, p<0.001). Group B had more hemoglobin (g/dl) drop (1.3 vs. 0.7, p<0.001) and need for blood transfusion (18.4% vs. 7.14%, p<0.001) and VAS score (p<0.001) than group A.Postoperative urosepsis was more common in group B. Efficacy in terms of successful renal access and stone clearance was comparable. The Alken dilator group has a lower rate of blood transfusion and postoperative VAS score. The Amplatz dilator group had more incidences ofpostoperative urosepsis. The efficacy in both groups was comparable.
Published Version
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