title: Comparison of Dilation Methods in Percutaneous Nephrolithotomy: Which One Is More Successful?
abstract: OBJECTIVE
  Creation of the access tract is an important step in percutaneous nephrolithotomy (PNL). In this study, we compared the efficiency and safety of Amplatz, Alken, and balloon dilation methods in the creation of the access tract.
  
  
  METHODS
  Data from 487 PNL patients admitted to 517 renal units in 3 centers were analyzed. The Amplatz (280 patients), Alken (142 patients), and balloon (95 patients) dilation methods were compared for their success, duration of the dilation, injury to the collecting system, durations of fluoroscopy and surgery, stone-free and complication rates, pre- and postoperative hematocrit levels, and need for blood transfusion.
  
  
  RESULTS
  The dilation methods did not significantly differ with respect to patient demographic data, mean stone area, decrease in hematocrit, need for blood transfusion, unsuccessful tract dilation, injury to the collecting system, stone-free rate, and rate of postoperative complications. The mean fluoroscopy times during Amplatz, Alken, and balloon dilation were 288.52 ± 164.67, 287.34 ± 164.99, and 169.23 ± 21 seconds, respectively. The mean duration of surgery was 96.48 ± 46.07, 94.72 ± 42.25, and 78 ± 25.96 minutes, respectively. The duration of tract creation was 328.67 ± 172.99, 325.14 ± 175.70, and 203.50 ± 32.76 seconds, respectively. The durations of surgery and tract creation were significantly shorter in the balloon dilation group.
  
  
  CONCLUSIONS
  None of the dilation methods was significantly superior in terms of surgical success, efficiency, or safety. Although balloon dilation was advantageous with respect to time parameters, the role of surgical experience should not be ignored.
authors.affiliation: 1 Clinics of Urology, Diskapi Training and Research Hospital , Ankara, Turkey .
authors.forename: Ismail
authors.initials: I
authors.lastname: Nalbant
authors.affiliation: 1 Clinics of Urology, Diskapi Training and Research Hospital , Ankara, Turkey .
authors.forename: Ahmet Nihat
authors.initials: AN
authors.lastname: Karakoyunlu
authors.affiliation: 2 Clinics of Urology, Medical Faculty, Gazi University , Ankara, Turkey .
authors.forename: Suleyman
authors.initials: S
authors.lastname: Yesil
authors.affiliation: 3 Clinics of Urology, Medical Faculty, Hitit University , Corum, Turkey .
authors.forename: Musa
authors.initials: M
authors.lastname: Ekici
authors.affiliation: 4 Clinics of Urology, Medical Faculty, Bozok University , Yozgat, Turkey .
authors.forename: Kursad
authors.initials: K
authors.lastname: Zengin
authors.affiliation: 1 Clinics of Urology, Diskapi Training and Research Hospital , Ankara, Turkey .
authors.forename: Ufuk
authors.initials: U
authors.lastname: Ozturk
authors.affiliation: 4 Clinics of Urology, Medical Faculty, Bozok University , Yozgat, Turkey .
authors.forename: Muhammed Abdurrahim
authors.initials: MA
authors.lastname: Imamoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004106:Dilatation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult