Outcome of tract dilation techniques in mini PCNL: Saldinger Technique vs. Single-Step Dilator 18 Fr.

Abstract

Objective: To compare the outcomes of Mini PCNL performed using Saldinger technique versus single-step dilator 18 Fr in terms of procedure time, per-operative blood loss, hospital stay, postoperative pain, and postoperative hematuria. Study Design: Prospective Analytic Research. Setting: Children Hospital, Faisalabad. Period: January 2023 to the December 2024. Methods: Total of 80 patients were randomly assigned to two groups: The Group A (Saldinger technique) and The Group B (single-step dilator 18 Fr). Outcomes were assessed and analyzed. Results: Total of 80 patients were equally divided into the “Saldinger” and “Single-Step dilation” groups. Mean age was similar between groups (Saldinger: 9.24 ± 2.09 years; Single-step: 9.27 ± 1.73 years). Gender distribution showed no significant difference (p = 0.361). The mean operative time was noted significantly longer in the Saldinger group (67.89 ± 9.82 min) compared to the Single-Step group (44.65 ± 4.75 min, p < 0.001). Conversely, mean preoperative blood loss was significantly lower in the Saldinger group (101.44 ± 14.90 ml) versus Single-Step (155.76 ± 9.63 ml, p < 0.001). Hospital stay was slightly longer in the Saldinger group (3.05 ± 0.43 days) than in Single-Step (2.79 ± 0.43 days, p = 0.009). Postoperative pain scores (VAS) and analgesia requirement were comparable between groups (p = 0.225 and p = 0.251, respectively). Hematuria grading showed no significant difference (p = 0.385). Conclusion: The Single-Step dilation technique significantly reduces procedure time and the hospital stay compared to the Saldinger technique, although which is associated with higher intraoperative blood loss. We did not find significant differences in post-operative pain, analgesia requirements, or hematuria severity between the two groups. These findings suggest that the Single-Step technique may be preferred for its efficiency, while the Saldinger technique offers advantages in reducing blood loss.