Browsing by Author "Endale Demeke"

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    Outcome and Associated Factors of Two-Step Tract Dilation in a Complete Radiation Free Percutaneous Nephrolithotomy at Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2025-12-07) Endale Demeke; Mesay Mekonen; Abeselom Lemma
    Introduction: Percutaneous Nephrolithotomy is the Treatment of Choice for Complex Renal Stones. As Fluoroscopy Carries a Risk of Radiation Exposure, Ultrasound Guidance Has Emerged as an Alternative to Fluoroscopic Guidance. Objective: To Assess the Outcome, Safety and Efficacy of Ultrasound-Guided Percutaneous Nephrolithotomy (PCNL) Using A Two-Step Tract Dilation Method. Methods And Materials: A Cross-Sectional Study was done on 130 Cases That Underwent Ultrasound-Guided PCNL From January 1 to December 30, 2024. The Tract Was Dilated in a Two Step Fashion. In Step 1, after Puncturing The PCS, The Tract Was Dilated To 12 Fr. Then, A 9.5 Fr URS Was Introduced to Evaluate the Tract, Manipulate the Guide Wire, And Scan the Kidney. Finally, In Step 2, the Tract was Dilated to the Required Size. We Evaluated Patients' Demographic Features, Stone Complexity Using the S.T.O.N.E. Nephrolithometry Score, Complications Using the Clavien-Dindo Grading System, And Hospital Stay. On Postoperative day 1, A KUB Was Performed to Assess Stone-Free Status. Postoperatively, Patients were Followed up with Abdominal Ultrasound in the Outpatient Clinic. Results: of the 130 Cases, 84 (64.6%) were Male, And the Mean Age at Presentation Was 39.9 Years. About 35(26.9%) of Patients Had a Previous History of Open Renal Surgery. In 80% of Patients, The Stone Complexity Score Measured By S.T.O.N.E Score Was Between 6 and 8. In 86.9% of patients, only A Single Tract Was Used and the Mean total Duration of Surgery Was 100 Minutes. The Median Hospital Stay Was 2 days. Approximately 77.7% of patients had No Complications. The Mean Hemoglobin Drop Was 1.69 G/Dl, and there was no need for Transfusion. Prolonged urine leak was the most common complication (9.2%), and transient elevation of creatinine was seen at 35/77(45%). the Early Stone-Free Rate was 75.4%. Conclusion: Ultrasound-guided PCNL with two-step tract dilation is an effective and safe modality for performing PCNL and holds significant importance in resource-limited areas.