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A Comparison of the Alken Metallic Telescopic Dilator and Amplatz Serial Dilator for Renal Access in Percutaneous Nephrolithotomy
Access to the renal calyx is a challenging and crucial step for a successful percutaneous nephrolithotomy (PCNL). There are different methods of access tract dilatation, and there is no consensus on which method is the best. We conducted a comparative retrospective study on the safety and efficacy o...
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Published in: | Curēus (Palo Alto, CA) CA), 2024-10, Vol.16 (10), p.e72509 |
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description | Access to the renal calyx is a challenging and crucial step for a successful percutaneous nephrolithotomy (PCNL). There are different methods of access tract dilatation, and there is no consensus on which method is the best. We conducted a comparative retrospective study on the safety and efficacy of the Alken metallic dilator and Amplatz dilator for renal access in PCNL.
We retrospectively reviewed the medical records of 80 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 |
doi_str_mv | 10.7759/cureus.72509 |
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We retrospectively reviewed the medical records of 80 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 of postoperative urosepsis. The efficacy in both groups was comparable.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.72509</identifier><identifier>PMID: 39610616</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Blood transfusions ; Body mass index ; Catheters ; Chi-square test ; Hemoglobin ; Oncology ; Patients ; Sepsis ; Standard deviation ; Student's t-test ; Urogenital system ; Urological surgery ; Urology ; Variables</subject><ispartof>Curēus (Palo Alto, CA), 2024-10, Vol.16 (10), p.e72509</ispartof><rights>Copyright © 2024, Khwairakpam et al.</rights><rights>Copyright © 2024, Khwairakpam et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Khwairakpam et al. 2024 Khwairakpam et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1775-4de9bb4dcb49971a6af6fd34714a12771c1700955de54fc00a05bb830850546d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3134455892/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3134455892?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25752,27923,27924,37011,37012,44589,53790,53792,74897</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39610616$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khwairakpam, Amitkumar</creatorcontrib><creatorcontrib>Singh, Somarendro Khumukcham</creatorcontrib><creatorcontrib>Sharan, Pratik</creatorcontrib><creatorcontrib>Adhikari, Aakash</creatorcontrib><creatorcontrib>Mehra, Devendra Singh</creatorcontrib><creatorcontrib>Yadav, Santosh</creatorcontrib><title>A Comparison of the Alken Metallic Telescopic Dilator and Amplatz Serial Dilator for Renal Access in Percutaneous Nephrolithotomy</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Access to the renal calyx is a challenging and crucial step for a successful percutaneous nephrolithotomy (PCNL). There are different methods of access tract dilatation, and there is no consensus on which method is the best. We conducted a comparative retrospective study on the safety and efficacy of the Alken metallic dilator and Amplatz dilator for renal access in PCNL.
We retrospectively reviewed the medical records of 80 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 of postoperative urosepsis. The efficacy in both groups was comparable.</description><subject>Blood transfusions</subject><subject>Body mass index</subject><subject>Catheters</subject><subject>Chi-square test</subject><subject>Hemoglobin</subject><subject>Oncology</subject><subject>Patients</subject><subject>Sepsis</subject><subject>Standard deviation</subject><subject>Student's t-test</subject><subject>Urogenital system</subject><subject>Urological surgery</subject><subject>Urology</subject><subject>Variables</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkUtv1TAQhS1ERavSHWtkiQ0LbjtO_EhWKLq8KpWHoKwtx5lwXZw4tROksus_x5ByVVhYHs98OvKZQ8gTBqdKifrMLhGXdKoKAfUDclQwWW0qVvGH9-pDcpLSFQAwUAUoeEQOy1oykEwekduGbsMwmehSGGno6bxD2vjvONL3OBvvnaWX6DHZMOXylfNmDpGasaPNMOXHT_oFozN-P-rz-Yxj7jTWYkrUjfQTRrvMZsSwJPoBp10M3s27MIfh5jE56I1PeHJ3H5Ovb15fbt9tLj6-Pd82FxvLstUN77BuW97Zlte1YkaaXvZdyRXjhhVKsYwB1EJ0KHhvAQyItq1KqAQILrvymLxcdaelHbCzOM7ReD1FN5h4o4Nx-t_J6Hb6W_ihGZNQcBBZ4fmdQgzXC6ZZDy5Z9H41pktWcpCVKFhGn_2HXoUl5qWsFBeiqotMvVgpG0NKEfv9bxjo3_nqNV_9J9-MP73vYA__TbP8BXDiow8</recordid><startdate>20241027</startdate><enddate>20241027</enddate><creator>Khwairakpam, Amitkumar</creator><creator>Singh, Somarendro Khumukcham</creator><creator>Sharan, Pratik</creator><creator>Adhikari, Aakash</creator><creator>Mehra, Devendra Singh</creator><creator>Yadav, Santosh</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241027</creationdate><title>A Comparison of the Alken Metallic Telescopic Dilator and Amplatz Serial Dilator for Renal Access in Percutaneous Nephrolithotomy</title><author>Khwairakpam, Amitkumar ; Singh, Somarendro Khumukcham ; Sharan, Pratik ; Adhikari, Aakash ; Mehra, Devendra Singh ; Yadav, Santosh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1775-4de9bb4dcb49971a6af6fd34714a12771c1700955de54fc00a05bb830850546d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Blood transfusions</topic><topic>Body mass index</topic><topic>Catheters</topic><topic>Chi-square test</topic><topic>Hemoglobin</topic><topic>Oncology</topic><topic>Patients</topic><topic>Sepsis</topic><topic>Standard deviation</topic><topic>Student's t-test</topic><topic>Urogenital system</topic><topic>Urological surgery</topic><topic>Urology</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khwairakpam, Amitkumar</creatorcontrib><creatorcontrib>Singh, Somarendro Khumukcham</creatorcontrib><creatorcontrib>Sharan, Pratik</creatorcontrib><creatorcontrib>Adhikari, Aakash</creatorcontrib><creatorcontrib>Mehra, Devendra Singh</creatorcontrib><creatorcontrib>Yadav, Santosh</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khwairakpam, Amitkumar</au><au>Singh, Somarendro Khumukcham</au><au>Sharan, Pratik</au><au>Adhikari, Aakash</au><au>Mehra, Devendra Singh</au><au>Yadav, Santosh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Comparison of the Alken Metallic Telescopic Dilator and Amplatz Serial Dilator for Renal Access in Percutaneous Nephrolithotomy</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2024-10-27</date><risdate>2024</risdate><volume>16</volume><issue>10</issue><spage>e72509</spage><pages>e72509-</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Access to the renal calyx is a challenging and crucial step for a successful percutaneous nephrolithotomy (PCNL). There are different methods of access tract dilatation, and there is no consensus on which method is the best. We conducted a comparative retrospective study on the safety and efficacy of the Alken metallic dilator and Amplatz dilator for renal access in PCNL.
We retrospectively reviewed the medical records of 80 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 of postoperative urosepsis. The efficacy in both groups was comparable.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>39610616</pmid><doi>10.7759/cureus.72509</doi><oa>free_for_read</oa></addata></record> |
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subjects | Blood transfusions Body mass index Catheters Chi-square test Hemoglobin Oncology Patients Sepsis Standard deviation Student's t-test Urogenital system Urological surgery Urology Variables |
title | A Comparison of the Alken Metallic Telescopic Dilator and Amplatz Serial Dilator for Renal Access in Percutaneous Nephrolithotomy |
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