On-line version ISSN 2078-5151
S. Afr. j. surg. vol.50 n.3 Cape Town Aug. 2012
A R KalpeeI; R VenterII; T FourieIII
IMB ChB; Department of Urology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban
IIMB ChB, FCUrol (SA); Department of Urology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban
IIIMB ChB, MMed (Urol); Department of Urology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban
OBJECTIVE: A new second-generation balloon dilatation device for percutaneous nephrolithotomy (PCNL) has been launched, promising to challenge the traditional Amplatz serial dilators (ASDs). This device allows for the polyurethane sheath to be deployed on balloon inflation. Our primary objective in this pilot study was to determine whether the use of this new device impacted on overall patient outcome when compared with the traditional ASD system.
DESIGN: Retrospective chart review.
SETTING: Department of Urology, Inkosi Albert Luthuli Central Hospital, Durban.
SUBJECT: Single-centre comparison of a novel single-step balloon inflation device and Amplatz sheath dilatation during percutaneous nephrolithotomy - a pilot study.
OUTCOME MEASURES: Single procedure success rates, retreatment rates, hospital stay, haemoglobin concentration, calculi volume, calculi configuration, patient demographics.
RESULTS: The stone-free rates after a single procedure were 30% (3/10) in the Amplatz sheath dilatation arm (series 1) and 80% (8/10) in the single-step balloon inflation device arm (series 2). Correspondingly, 11 individual repeat procedures in 7 patients (4 relook PCNLs, 5 ureteroscopies and 2 extracorporeal shockwave lithotripsies) were required in series 1 to render the remaining 70% stone free. Mean hospital stay was 5.2 days (range 3 - 10 days) in series 1 and 3.8 days in series 2. The mean fall in haemoglobin concentration after treatment was 1.79 g/dl in the whole group, 2.1 g/dl in series 1, and 1.5 g/dl in series 2.
CONCLUSION: The single-step balloon dilatation device is found to have an improved patient outcome compared with ASDs.
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