Unilateral combined lap partial nephrectomy and pyelolithotomy for ipsilateral tumor & kidney staghorn stone


DOI: https://dx.doi.org/10.18565/urology.2021.3.87-91

A.D. Kochkin, E.A. Gallyamov, V.L. Medvedev, R.G. Biktimirov, A.B. Novikov, A.E. Sanzharov, F.A. Sevryukov, V.P. Sergeev

1) «Privolzhskiy Research Medical University», Nizhny Novgorod, Russia; 2) Urological Center of Russian Railways Hospital, Nizhny Novgorod, Russia; 3) I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University) Moscow, Russia; 4) Kuban State Medical University, Krasnodar, Russia; 5) Federal Clinical Center for HMT, FMBA of Russia, Khimki, Russia; 6) Federal Scientific and Clinical Center, FMBA of Russia, Moscow, Russia; 7) Multidisciplinary Medical Center of the Bank of Russia, Moscow, Russia; 8) A.I. Burnazyan SRC FMBC, FMBA of Russia, Moscow, Russia
Objective: To discuss the feasibility, safety, and effectiveness of conventional laparoscopic partial nephrectomy combined with pyelolithotomy for patients with ipsilateral renal tumor and staghorn kidney stone. Materials and methods: Retrospective multicentral comparative study. Group “Combo” was presented by patients with the mentioned combined pathology (n=15). Group “Standart” (n=69) formed from common patients who underwent standard lap partial nephrectomy for renal tumor in the absence of kidney stones. Perioperative factors and results were studied and compared. Video presentation of combined surgical technique is available at: https://youtu.be/fAfYJDvGzsU. Results: Of all patients, no positive margins, no conversions to open surgery or nephrectomy & any complications Clavien >III were detected. There were no any significant differences between the two groups except for OR time (150 [120; 210] vs 130 [100; 180] min; p=0,001). Differences between indexes of WIT (16,27±3,8 vs 15,9±4,5 min; p=0,107), EBL (200 [150; 300] vs 200 [150; 300] cc; p=0,981), length of stay (7 [6;9] vs 8[6;9] days; p=0,611), intraop complications (0,00 vs 4,3%; p=0,411) and values of postop Clavien III rate (0,00 vs 4,3%; p=0,411) for “Combo” & “Standart” respectively were comparable as well as oncological outcomes. Stone-free rate for combined procedures reached 93,3%. Conclusion: conventional laparoscopic partial nephrectomy combined with pyelolithotomy for patients with ipsilateral renal tumor and staghorn kidney stone is safe and efficient alternative to 2-step treatment of this rare disease.

About the Autors


Corresponding author: A.D. Kochkin – MD, Ph.D., Urologist at the Urological Center of Russian Railways Hospital, Nizhny Novgorod, Russia. Teaching Assistance at the «Privolzhskiy Research Medical University», Nizhny Novgorod, Russia; e-mail: kochman@bk.ru


Similar Articles


Бионика Медиа