Русский
Percutaneous nephrolithotomy in patients with solitary kidney
DOI: https://dx.doi.org/10.18565/urology.2020.2.107-112
B.G. Guliev, A.E. Talyshinslyi
1 Department of urology (Head – prof. B.K. Komyakov) of North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia; 2 Center of Urology with robot-assisted surgery of City Mariinsky hospital (Chief – prof. O.V. Emeliyanov), Saint Petersburg, Russia
Percutaneous nephrolithotomy (PCNL) is the method of choice for large and staghorn renal stones, including those in patients with solitary kidney. The aim of the literature review was to analyze the results of PCNL in patients with large stones in the solitary kidney.
The literature search was conducted in databases Embase, Medline, Google Scholar, Scopus for the period from 2010 to 2019. A total 94 articles were selected, of which 16 papers were included in the review after analyzing the abstracts. Data was pooled and analyzed using SPSS Statistics 22.0.
The primary stone-free rate for PCNL in these patients was 68.3±14.2%, and the final stone-free rate increased by 86.5±4.9%. The average duration of the operation was 86±25 (43.7–138.3) min, the length of stay was 5 (2–6) days. The baseline creatinine level was 137 (110–200) mmol/L, compared to 142 (122–183) mmol/L postoperatively. The mean difference between the baseline and postoperative Hb level was 7.8 (1.3–17.5) g/l. The estimated glomerular filtration rate (GFR) before PCNL was 62.3±7.5 ml/min/1.73 m2, and it did not exceed 62.5±9.3 ml/min/1.73 m2 postoperatively. The overall complication rate ranged from 10.6 to 68.8%, averaging 29.9%. In most cases, there were grade I and II complications, according to Clavien-Dindo classification, which didn’t require additional interventions.
PCNL is a highly effective treatment method for patients with large stones in solitary kidney. Complications rate is relatively low, which is achieved by an individual approach, with a consideration of the condition and all risk factors.
The literature search was conducted in databases Embase, Medline, Google Scholar, Scopus for the period from 2010 to 2019. A total 94 articles were selected, of which 16 papers were included in the review after analyzing the abstracts. Data was pooled and analyzed using SPSS Statistics 22.0.
The primary stone-free rate for PCNL in these patients was 68.3±14.2%, and the final stone-free rate increased by 86.5±4.9%. The average duration of the operation was 86±25 (43.7–138.3) min, the length of stay was 5 (2–6) days. The baseline creatinine level was 137 (110–200) mmol/L, compared to 142 (122–183) mmol/L postoperatively. The mean difference between the baseline and postoperative Hb level was 7.8 (1.3–17.5) g/l. The estimated glomerular filtration rate (GFR) before PCNL was 62.3±7.5 ml/min/1.73 m2, and it did not exceed 62.5±9.3 ml/min/1.73 m2 postoperatively. The overall complication rate ranged from 10.6 to 68.8%, averaging 29.9%. In most cases, there were grade I and II complications, according to Clavien-Dindo classification, which didn’t require additional interventions.
PCNL is a highly effective treatment method for patients with large stones in solitary kidney. Complications rate is relatively low, which is achieved by an individual approach, with a consideration of the condition and all risk factors.
Keywords: percutaneous removal of stones, stone procedures, percutaneous nephrolithotomy, solitary kidney, urolithiasis
About the Autors
Corresponding author: B.G. Guliev – MD, professor at the Department of Urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Head of Center of Urology with robot-assisted surgery of City Mariinsky hospital, Saint Petersburg, Russia; e-mail: gulievbg@mail.ru
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