Русский
A comparative analysis of simultaneous bilateral versus staged supine mini-percutaneous nephrolithotomy in patients with bilateral kidney stones
DOI: https://dx.doi.org/10.18565/urology.2019.2.31-35
A.S. Panferov, S.V. Kotov
1) Medical Center “Medassist”, “Medassist-K” Ltd, Kursk, Russia; 2) FGBOU VO Russian National Research Medical University named after N.I. Pirogov of Minzdrav of Russia, Moscow, Russia; 3) N.I. Pirogov City Clinical Hospital №1, Moscow, Russia
Aim. To evaluate feasibility and efficiency of simultaneous bilateral supine mini-percutaneous nephrolithotomy in patients with bilateral kidney stones.
Materials and methods. A total of 79 patients were included in prospective, randomized study. Single-stage bilateral supine mini-percutaneous nephrolithotomy was performed in the main group (n=37), while in control group (n=42) staged mini-percutaneous nephrolithotomy was done. All interventions were performed in supine position. A type and severity of postoperative complications, changes in biomarkers of acute kidney injury including serum creatinine, glomerular filtration rate (GFR) and cystatin C level were evaluated. The follow-up was 6 months.
Results. Stone-free rate in main and control groups was 89.1% and 88.9%, respectively, while the mean duration of the surgery was 82.76 and 140.14 minutes, respectively (p<0.05). There were no significant differences in the type and rate of postoperative complications between groups. Recovery time was significantly shorter in the main group (8.44 vs. 17,76±2,41 days, respectively [p<0.05]).
There were significant changes in serum creatinine and cystatin C levels on 1st day after surgery compared to baseline values and between groups. However, the level of GFR didn’t significantly change in both groups. After 1 month, an increase in GFR in the main group was 6.9% in comparison with 6.8% in control group.
Conclusion. Our study demonstrates that simultaneous bilateral mini-percutaneous nephrolithotomy is a safe and effective treatment option for patients with bilateral kidney stones.
Materials and methods. A total of 79 patients were included in prospective, randomized study. Single-stage bilateral supine mini-percutaneous nephrolithotomy was performed in the main group (n=37), while in control group (n=42) staged mini-percutaneous nephrolithotomy was done. All interventions were performed in supine position. A type and severity of postoperative complications, changes in biomarkers of acute kidney injury including serum creatinine, glomerular filtration rate (GFR) and cystatin C level were evaluated. The follow-up was 6 months.
Results. Stone-free rate in main and control groups was 89.1% and 88.9%, respectively, while the mean duration of the surgery was 82.76 and 140.14 minutes, respectively (p<0.05). There were no significant differences in the type and rate of postoperative complications between groups. Recovery time was significantly shorter in the main group (8.44 vs. 17,76±2,41 days, respectively [p<0.05]).
There were significant changes in serum creatinine and cystatin C levels on 1st day after surgery compared to baseline values and between groups. However, the level of GFR didn’t significantly change in both groups. After 1 month, an increase in GFR in the main group was 6.9% in comparison with 6.8% in control group.
Conclusion. Our study demonstrates that simultaneous bilateral mini-percutaneous nephrolithotomy is a safe and effective treatment option for patients with bilateral kidney stones.
About the Autors
Corresponding author: A.S. Panferov – chief of Urologic Center of Medical Center “Medassist”, “Medassist-K” Ltd, Kursk, Russia; e-mail: panferov-uro@yandex.ru
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