title: Evaluation of a novel fascial dilator modified with scale marker in percutaneous nephrolithotomy for reducing the X-ray exposure: a randomized clinical study.
abstract: OBJECTIVE
  To evaluate the role of the fascial dilators modified with a scale marker in reducing fluoroscopy time during percutaneous nephrolithotomy (PCNL).
  
  
  METHODS
  In a randomized clinical trial, eligible 100 consecutive patients anticipated to undergo single-tract PCNL were randomly assigned into two groups by the closed envelope method, to compare the efficacy and safety of the modified scale fascial dilator (group 1, n=50) and traditional nonscale fascial dilator (group 2, n=50) with respect to the X-ray exposure duration as well as the outcome of PCNL.
  
  
  RESULTS
  There was no significant difference between group 1 and group 2 regarding to the initial successful access rate (100% v 96%), operative time (79.4 v 83.7 minutes), the initial stone-free rate (82% v 81.3%), complications (24% v 20%), and bleeding required blood transfusion (4% v 6%) (all p>0.05). The mean operative duration and fluoroscopic time for tract dilation in group 1 and group 2 were 164.4 ± 19 seconds v 168.3 ± 14 seconds, and 3.2 ± 0.9 seconds v 22.2 ± 4.6 seconds, (p=0.250 and p<0.001), respectively.
  
  
  CONCLUSIONS
  Compared to the use of nonscaled dilators, using the scaled fascial dilators for a percutaneous access in PCNL was found to be associated with less radiation hazards along with similar stone-free rate and complications.
authors.affiliation: 1 Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .
authors.forename: Guohua
authors.initials: G
authors.lastname: Zeng
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Zhao
authors.forename: Wen
authors.initials: W
authors.lastname: Zhong
authors.forename: Kaijun
authors.initials: K
authors.lastname: Wu
authors.forename: Wenzhong
authors.initials: W
authors.lastname: Chen
authors.forename: Wenqi
authors.initials: W
authors.lastname: Wu
authors.forename: Chenlin
authors.initials: C
authors.lastname: Xiao
authors.forename: Yongda
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D004106:Dilatation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome