COMPARISON OF USING J TIP GUIDE WIRE VS STRAIGHT TIP GUIDE WIRE DURING PUNCTURE AND TRACT FORMATION IN PCNL

Percutaneous nephrolithotomy (PCNL) is a widely used surgical technique for removing large or complex kidney stones. The choice of guide wire during puncture and tract formation may influence the procedure's ease, safety, and success. Objective: This study aimed to compare J-tip guide wire versus straight-tip guide wire during puncture and tract formation in PCNL, focusing on ease of use, safety, and clinical outcomes. Methods: A comparative study was conducted at CMH, Lahore, from April 2024 to July 2024. A total of 89 patients were randomly assigned into two groups: Group A, using the J tip guide wire (n=45), and Group B, using the straight tip guide wire (n=44). Data were collected on ease of insertion, complication rates, procedural duration, and success rates. Statistical analysis was performed using SPSS software, with p<0.05 considered statistically significant. Results: The average age of patients in Group A was 52.3 ± 10.4 years and in Group B, 50.7 ± 11.2 years. Group A demonstrated significantly better ease of insertion with a mean score of 8.7 ± 0.9 compared to 7.5 ± 1.2 in Group B (p=0.003). Complication rates were lower in Group A (4.4%) versus Group B (22.7%, p=0.024), with fewer minor traumas (4.4% vs. 15.9%, p=0.048). The procedure duration was shorter in Group A (25.4 ± 5.1 minutes) compared to Group B (30.2 ± 6.3 minutes, p=0.001). The success rate was higher in Group A (97.8% vs. 90.9%), although this difference was not statistically significant (p=0.092). Conclusion: The J tip guide wire shows significant advantages over the straight tip guide wire in PCNL procedures, offering improved ease of use, reduced complication rates, and shorter procedural duration. These findings suggest that the J tip guide wire is valuable for enhancing PCNL outcomes.