balloon dilation

Percutaneous Nephrolithotomy (PCNL) is a gold standard in the management of complex renal stone ≥2 cm in diameter. Controversy exists regarding the optimal tract dilatation method in PCNL. The aim of this study was to compare the safety and complication rate of the balloon dilatation technique with telescopic method in nephrostomy tract dilation in percutaneous nephrolithotomy patients. This clinical trial study conducted on, 89 patients underwent PCNL in our center. Patients were divided into two groups according to dilation technique used: balloon dilatation technique group (28 patient) and telescopic technique group (61 patient). Patients matched according to sex and age. X-ray exposure time, blood loss, and complications were evaluated. The rate of stone free in balloon dilatation technique group was 100% and in telescopic one 80.3% (P=0.007). Hemoglobin decrease in balloon dilatation were 1.6±0.2 g/dl and in telescopic were 1.8±0.1 g/dl; No significant difference about hemoglobin reduction was seen in both groups (P=0.7). X-ray exposure time was 1.8±0.8 minute in balloon technique group and1.7±1.2 minute in telescopic group. The average of radiation dose was not significant difference between two techniques (P=0.1). We have not major complication in two groups. Both techniques of nephrostomy tract dilatation were effective with no significant differences in major complications. Rate of hemorrhage were similar in both of balloon dilatation and telescopic technique.

Achalasia is a motility disorder of unknown etiology. Diagnostic techniques include Barium esophagram, simple and widely available, radionuclide transit/emptying scintigraphy, a low-cost procedures, easy to perform and widely available, well tolerated and require minimum cooperation by patients and esophageal manometry that continues to be used widely in clinical practices, primarily because of its perceived value. Aim of this study was to compare methods of manometry, barium swallow and scintigraphy before and after pneumatic dilation.Methods and Materials: 17 patients with achalasia of cardia were evaluated both symptomatically and objectively (esophageal manometry, timed barium esophagram, and scintigraphic emptying index) before treating them with pneumatic dilation and after. The degree of patient symptom improvement post therapy was recorded and correlated with improvement of three methods indices. The degree of improvement after treatment was determined as the percentage of reduction of symptoms, divided into two groups (1) <80% improvement; (2) success: ≥80% improvement. 12 (70.6%) of patients had score improvement of ≥80%. All the diagnostic indices were significantly different between pre and post therapy. But, there was not significant difference between two groups of symptom improvement for indices of barium swallow or scintigraphy and also any association or correlation between patient symptom score and barium height improvement or emptying index improvement. We yielded 70.6% short-term good result after PD, similar to other studies. Our results showed that transit or barium study should not be relied upon in isolation for assessment of the efficacy of treatment.