Percutaneous nephrolithotomy in patients with previous open nephrolithotomy: one-shot versus telescopic technique for tract dilatation.

BACKGROUND AND PURPOSE Percutaneous nephrolithotomy (PCNL) can be done in patients who have previously had open nephrolithotomy. Currently, dilatation of the nephrostomy tract is achieved using an Amplatz renal dilator or telescopic metal dilators in these patients. The aim of this study was to compare the safety and efficacy of the "one-shot" procedure in patients with previous open nephrolithotomy with those of the current telescopic technique. PATIENTS AND METHODS Thirty-one patients with past history of open surgery for kidney stone disease underwent PCNL at our institution from February 2006 to March 2007. Patients were randomly divided into two groups according to dilation technique used: group A (telescopic procedure) and group B (one-shot procedure). X-ray exposure, blood loss, and complications were evaluated. RESULTS No significant difference in hemoglobin decrease was seen in the two groups. The stone-free and complication rates were the same in the two groups. Fluoroscopy time during the one-shot procedure was significantly shorter than that of the telescopic procedure (P < 0.000). CONCLUSION Our experience indicated that the one-shot procedure is feasible in patients with previous open nephrolithotomy. It is as safe and effective as the telescopic procedure, with significant reduction in x-ray exposure.