Comparison of Single-Step Balloon Dilatation and Serial Metallic Dilatation during Percutaneous Nephrolithotomy
DOI:
https://doi.org/10.51985/Keywords:
Percutaneous nephrolithotomy; balloon dilatation; tract dilatation; renal calculi; stone clearance; hemoglobin.Abstract
Objective: To compare perioperative outcomes of single-step balloon dilatation and serial metallic dilatation during percutaneous nephrolithotomy (PCNL).
Study Design and Setting: Prospective comparative quasi-experimental study conducted in the Department of Urology, Bahawal Victoria Hospital, Bahawalpur.
Methodology: A total of 214 adults with 2-4 cm renal stones were enrolled by consecutive sampling and treated in two groups of 107 according to the study protocol: single-step balloon dilatation or serial metallic dilatation. Outcomes included tract-creation time, operative time, hemoglobin drop, stone clearance, blood transfusion, postoperative fever, collectingsystem injury, and hospital stay. Continuous outcomes were compared with independent-samples t tests. For categorical outcomes, Pearson chi-square was used when expected cell counts were adequate and Fisher exact test when expected counts were small.
Results: Single-step balloon dilatation was associated with shorter tract-creation time (2.42 +/- 0.54 vs 4.08 +/- 0.67 min, p<0.001), shorter operative time (88.9 +/- 18.6 vs 97.4 +/- 20.9 min, p=0.002), lower hemoglobin drop (1.08 +/- 0.39 vs 1.43 +/- 0.46 g/dL, p<0.001), and shorter hospital stay (2.44 +/- 0.79 vs 3.04 +/- 0.92 days, p<0.001). Stone clearance was 87.9% versus 72.9% (Pearson chi-square p=0.006). Transfusion occurred in 2.8% versus 9.3% (Pearson chi-square p=0.045). Conclusion: In this study, single-step balloon dilatation was associated with shorter tract-creation and operative times, lower hemoglobin drop, shorter hospital stay, and higher observed stone clearance than serial metallic dilatation
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