Comparative Analysis of Balloon Tract Dilator and Metal Telescopic Dilators for Percutaneous Nephrolithotomy in Thai Patient Population
Keywords:
Balloon dilator, Alken metal dilators, Percutaneous nephrolithotomyAbstract
Background: Balloon dilators for percutaneous nephrolithotomy (PCNL) have been adopted in various countries worldwide. However, its utilization remains limited in Thailand due to the equipment cost and the country's higher morbidity and complexity of renal stones. We performed a comparative study between the outcomes of balloon dilators (BD) and the commonly used metal telescopic dilators (MTDs) in Thai patients who underwent PCNL.
Methods: We conducted a retrospective review of 199 patients who underwent PCNL between Jan 2011 and July 2022. We excluded patients with risk for bleeding and active infection from our study. 144 patients were recruited in our study: 74 patients in the MTD group and 70 patients in the BD group. The success rate and complication of both methods of dilation were compared. Continuous demographic data was compared with an independent t-test. A generalized linear model was applied to assess the multivariable analysis's mean differences and risk differences.
Results: Demographic data of patients in both groups were not significantly different in size of stone, age, and history of kidney surgery. The success rate of dilatation was 95.5% and 98.6% for MTD and BD, respectively (p = 0.331). Renal pelvic injury was 8.1% for MTD and 10% for BD (p = 0.692). Stone clearance rates were 100% and 82.48% for MTD and BD, respectively (p = 0.098). LOS of both groups was not significantly different by multivariate analysis.
Conclusion: Both dilatation methods demonstrated comparable success rates, blood loss, and hospital stays in PCNL for renal stones. In the Thai population with a high prevalence of large renal stones, BD remains an effective option in most situations.
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