Research on peroperative and postoperative effects of the amplatz and balloon dilatation methods applied in percutaneous nephrolithotomy

In percutaneous nephrolithotomy (PCNL) surgery, the technique used for creating the nephrostomy tract, is an important step that can affect the surgery and results of after surgery. In this study the peroperative and postoperative effects of Amplatz and balloon dilatation techniques were compared.PNL was applied in 194 patients using Amplatz dilatation technique between March 2006 and April 2010, and PNL applied using the technique of balloon dilatation in 54 patients between October 2010 and March 2012 datas, were evaluated with match-pair analysis method. Four patients whom balloon dilatation aplied, were excluded from the study because of suitable match-pair could not be found. Balloon dilatation aplied 50 patients (Group 1) and the appropriate criteria for their match-pair analysis of 50 patients with Amplatz dilatation (Group 2) were compared. Match-pair analysis criteria were taken as, gender, age, stone burden, stone location, previous surgery or ESWL history, the presence of obstruction in intravenous urography, diabetes mellitus and body mass index.Ages of patients and stone burden in Group 1 and 2 were 46 (14-77); 45 (14-74), and 485,7mm² ; 535 mm², respectively. Groups, respectively, compared with the duration of operation 105 (45-161) min and 106 (40-210) min (p = 0,838), times until access 13,3 min and 21,5 min (p <0,001), total fluoroscopy time 7,8 min and 10 min (p = 0,017), the total fluoroscopy time to access 1,42 min and 2,29 min (p = 0,03), duration of fluoroscopy after akses 6,42 min and 7,7 min (p = 0,075) were found to be. Study, a total of 70 patients stone-free, 14 patients clinically insignificant residual and 8 patients in both groups were remaining of stone, as concluded.The amount of radiation exposure is an important factor in the process of PNL. Balloon dilatation was significantly shortened the tract creation time, total and until access fluoroscopy time. In increasing stone burdens balloon dilatation can be applied with success and lower rates of bleeding than the Amplatz dilatation. Balloon dilatation is a technique that can be applied effectively and safely in patients with a history of previous surgery and ESWL.