The relative performance of balloon dilatators and metallic telescopic dilatators for the establishment of ultrasound-guided percutaneous nephrolithotomy tracts: a single-center, retrospective study.

PURPOSE

This study was developed to compare the clinical benefits associated with the use of balloon dilatators to those of metallic telescopic dilatators when used for the establishment of tracts in patients undergoing ultrasound-guided percutaneous nephrolithotomy.

MATERIALS AND METHODS

This was a single-center retrospective study enrolling patients with urolithiasis who underwent ultrasound-guided percutaneous nephrolithotomy at Yuhuangding Hospital between 2011 and 2021. Patients were grouped based on the method used to establish percutaneous renal tracts, including balloon and metallic telescopic groups. The primary outcomes were overshooting rate, failure of access rate, and the efficiency of stone removal, while secondary outcomes included safety and economic benefits.

RESULTS

In total, 2269 patients were enrolled in this study, of whom 1222 (54%) and 1047 (46%) were in the balloon and metallic telescopic groups, respectively. Comparisons between the two groups did not reveal any superiority of the balloon group relative to the metallic telescopic group in overshooting rate (adjusted rate ratio (RR), 0.97; 95% confidence interval (CI), 0.73-1.27), failure of access rate (adjusted RR, 0.78; 95% CI, 0.52-1.16) and stone removal efficiency (adjusted RR, 1.03; 95% CI, 0.94-1.13). However, a significantly lower postoperative hemoglobin reduction value was observed in the balloon group relative to the metallic telescopic group (adjusted beta coefficient ratio: 7.19, 95% CI, 5.68-8.70). Balloon dilatator use was associated with better transfusion, embolization, surgical time, and hospital stay outcomes, whereas it was inferior in terms of costs.

CONCLUSION

In patients undergoing ultrasound-guided percutaneous nephrolithotomy, balloon dilatator use for the establishment of percutaneous tracts is not superior to metallic telescopic dilatator use in terms of overshooting and failure of access and stone removal rates, but is superior in terms of the control of bleeding.