Innovative Metal Dilators for Percutaneous Nephrostomy Tract: Report on 546 Cases

Abstract

Objectives A retrospective study was conducted to evaluate the efficacy and safety of creating a percutaneous nephrostomy tract for stone removal with innovative metal dilators. Methods A total of 546 percutaneous nephrolithotomies was performed at Chiayi Christian Hospital from January 2001 to December 2005. Innovative metal dilators were used to create 546 percutaneous nephrostomy tracts in 520 patients. Several patients had multiple percutaneous nephrostomy tracts. Patient age, stone burden, operative time, stone-free rate, postoperative hospital day, postoperative urinary tract infection rate, and blood transfusion rate were recorded using retrospective chart review. Results The dilation time was less than 15 minutes. The average patient age was 53.7 ± 13.1 years, and the average stone size was 3.5 ± 2.0 cm. The average operative time was 100 ± 45 minutes. The average postoperative hospital stay was 4.4 ± 2.6 days. The overall stone-free rate was 84.4% (461 of 546). The stone-free rate was 99% (142 of 143) for upper ureteral stones, 87% (268 of 305) for renal stones, and 52% (51 of 98) for complete staghorn stones. The blood transfusion rate was 2.5% (14 of 546). The postoperative urinary tract infection rate was 8.6% (47 of 546). Of the 520 patients, 6 had pleural effusion and 1 had pneumothorax. Conclusions Our innovative metal dilators saved time, resulted in less bleeding, and successfully provided one-stage tract creation in 520 patients. The dilation system also allowed the use of a ureteroscope to check the entrance tract to reduce complications.