| Renal Parenchymal Damage After Percutaneous Nephrolithotomy with One-Stage Tract Dilation Technique: A Randomized Clinical Trial. | |
| | |
MedLine Citation:
|
PMID: 21542774 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Abstract Purpose: To compare the effects of one-stage vs gradual dilation techniques during percutaneous nephrolithotomy (PCNL) on postoperative renal scar formation and overall renal function. Patients and Methods: Of 152 adult patients who underwent surgery during the study period, 48 were randomized into two groups. In group 1 (n=19), gradual tract dilation with Alken metallic dilators was used, and in group 2 (n=29), one-stage tract dilation was used. We compared patient demographics, intraoperative and preoperative parameters, postoperative overall renal function, and renal scar formation on the target renal pole. Results: Access time (P=0.001; 95% confidence interval [CI]: 3.19-6.30) and radiation exposure during access (P=0.03; 95% CI: 0.03-0.66) were significantly shorter in group 2. In group 1, the decrease in mean technetium-99m dimercaptosuccinic acid (99m-Tc DMSA) uptake from 44.1±20.1% to 43.4±19.6% 4 weeks postoperatively (-0.7%±0.5%; P=0.27; 95% CI: -0.56-1.93) was not significant. In group 2, however, there was a significant decrease in post-PCNL 99m-Tc DMSA uptake 2 (-2.4±0.3%, from 50.1±13.5% to 47.7±13.8%; P=0.001; 95% CI: 1.13-3.66). Four weeks after surgery, new scar formation or progression of the preoperative scar at the site of access were seen in 14 of 29 (48.3%) patients who were treated with one-stage dilation whereas only 2 of 19 (11.0%) patients who were treated with gradual dilation developed new scarring at the access site (P=0.007). Conclusion: Although the one-stage tract dilation technique reduced radiation exposure and access time, in the short term, it may cause more parenchymal damage than the gradual dilation technique. |
| | |
Authors:
|
Alireza Aminsharifi; Mehrosadat Alavi; Ghasem Sadeghi; Saeed Shakeri; Firoozeh Afsar |
Related Documents
:
|
21372564 - Evaluation of different perfusion durations in direct hemoperfusion with polymyxin b-im... 21270724 - Psoas compartment block for acute postoperative pain management after hip surgery in pe... 21534244 - Combination of maintenance hemodialysis with hemoperfusion: a safe and effective model ... 791974 - Parkinsonism and levodopa: a five-year experience. 16702494 - Randomized controlled trial of adjuvant oral dexamethasone pulse therapy in pemphigus v... 1567114 - Open tip rhinoplasty. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-5-4 |
Journal Detail:
|
Title: Journal of endourology / Endourological Society Volume: - ISSN: 1557-900X ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-5-5 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8807503 Medline TA: J Endourol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1 Department of Urology, Shiraz University of Medical Sciences , Shiraz, Iran . |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Floseal Reduces the Incidence of Lymphoceles After Lymphadenectomies in Laparoscopic and Robot-Assis...
Next Document: Laparoendoscopic Single-Site Surgery for Left Adrenalectomy: Standardization of Technique.