Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study
Background: Urinary tract stones is one of the most frequent medical emergencies which leads to lifethreatening complications, namely obstructive uropathy as well as renal failure in some situations. Previously, bilateral stones were treated with either open surgery or percutaneous nephrolithotomy...
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| Format: | Article |
| Language: | English |
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Electronic Physician
2018-02-01
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| Series: | Electronic Physician |
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878033/ |
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| author | Mohammad Reza Darabi Salman Soltani Alireza Akhavan Rezayat Masoud Yousefi Mehdi Kashefi Mahmoud Tavakkoli Shabnam Mohammadi |
| author_facet | Mohammad Reza Darabi Salman Soltani Alireza Akhavan Rezayat Masoud Yousefi Mehdi Kashefi Mahmoud Tavakkoli Shabnam Mohammadi |
| author_sort | Mohammad Reza Darabi |
| collection | DOAJ |
| description | Background: Urinary tract stones is one of the most frequent medical emergencies which leads to lifethreatening
complications, namely obstructive uropathy as well as renal failure in some situations. Previously,
bilateral stones were treated with either open surgery or percutaneous nephrolithotomy (PCNL). However, these
treatment options were associated with lengthy operation time, need for more anesthesia, further bleeding, and
long hospitalization. Therefore, much effort has been made to treat both sides simultaneously.
Objective: The aim of this study was an attempt to prospectively review cases undergoing simultaneous bilateral
PCNL in terms of the therapy outcomes, complications, and consequences.
Methods: In this prospective cohort study, 39 adult patients with bilateral renal stones were randomly recruited at
Imam Reza hospital in Mashhad, Iran between January 2016 and January 2017. Adult patients with bilateral renal
stones were included in this study. Exclusion criteria were as follows: Patients with severe heart or lung disease,
patients with coagulation disorders, pregnant women, and cases with any contraindications for general anesthesia.
After insertion of bilateral ureteral catheters, all patients underwent simultaneous bilateral PCNL in prone
position. Transureteral lithotripsy was performed for patients with ureteral stones. The surgery was initially
carried out on the symptomatic side and then iterated on the remaining kidney. Major complications including
bleeding, fever, pain, urine leakage, and residual stones were recorded. SPSS software was used for data analysis.
Data were expressed as percentage and mean ± SD. P value less than 0.05 was considered significant.
Results: A total of 39 patients (27 males with mean age of 37.6 years and 12 females with mean age of 45.7
years) were studied. As many as 15 (38%) patients received a unilateral nephrostomy. Three underwent totally
tubeless surgery. Bleeding (41.0%) was the most common complication, followed by residual stones (20.5%) and
fever (20.5%), urine leakage (15.3%), pain (12.8%), blood transfusion (2.5%) and colon perforation (2.5%).
Conclusions: It was concluded that simultaneous bilateral PCNL was not associated with higher morbidity than
the unilateral method |
| first_indexed | 2024-12-11T23:57:59Z |
| format | Article |
| id | doaj.art-ac16fb9ff5124fac8f2d08223cc83d6c |
| institution | Directory Open Access Journal |
| issn | 2008-5842 2008-5842 |
| language | English |
| last_indexed | 2024-12-11T23:57:59Z |
| publishDate | 2018-02-01 |
| publisher | Electronic Physician |
| record_format | Article |
| series | Electronic Physician |
| spelling | doaj.art-ac16fb9ff5124fac8f2d08223cc83d6c2022-12-22T00:45:18ZengElectronic PhysicianElectronic Physician2008-58422008-58422018-02-011026377638210.19082/6377Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort studyMohammad Reza DarabiSalman SoltaniAlireza Akhavan RezayatMasoud YousefiMehdi KashefiMahmoud TavakkoliShabnam MohammadiBackground: Urinary tract stones is one of the most frequent medical emergencies which leads to lifethreatening complications, namely obstructive uropathy as well as renal failure in some situations. Previously, bilateral stones were treated with either open surgery or percutaneous nephrolithotomy (PCNL). However, these treatment options were associated with lengthy operation time, need for more anesthesia, further bleeding, and long hospitalization. Therefore, much effort has been made to treat both sides simultaneously. Objective: The aim of this study was an attempt to prospectively review cases undergoing simultaneous bilateral PCNL in terms of the therapy outcomes, complications, and consequences. Methods: In this prospective cohort study, 39 adult patients with bilateral renal stones were randomly recruited at Imam Reza hospital in Mashhad, Iran between January 2016 and January 2017. Adult patients with bilateral renal stones were included in this study. Exclusion criteria were as follows: Patients with severe heart or lung disease, patients with coagulation disorders, pregnant women, and cases with any contraindications for general anesthesia. After insertion of bilateral ureteral catheters, all patients underwent simultaneous bilateral PCNL in prone position. Transureteral lithotripsy was performed for patients with ureteral stones. The surgery was initially carried out on the symptomatic side and then iterated on the remaining kidney. Major complications including bleeding, fever, pain, urine leakage, and residual stones were recorded. SPSS software was used for data analysis. Data were expressed as percentage and mean ± SD. P value less than 0.05 was considered significant. Results: A total of 39 patients (27 males with mean age of 37.6 years and 12 females with mean age of 45.7 years) were studied. As many as 15 (38%) patients received a unilateral nephrostomy. Three underwent totally tubeless surgery. Bleeding (41.0%) was the most common complication, followed by residual stones (20.5%) and fever (20.5%), urine leakage (15.3%), pain (12.8%), blood transfusion (2.5%) and colon perforation (2.5%). Conclusions: It was concluded that simultaneous bilateral PCNL was not associated with higher morbidity than the unilateral methodhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878033/Bilateral calculiComplicationsPercutaneous nephrolithotomyPCNL |
| spellingShingle | Mohammad Reza Darabi Salman Soltani Alireza Akhavan Rezayat Masoud Yousefi Mehdi Kashefi Mahmoud Tavakkoli Shabnam Mohammadi Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study Electronic Physician Bilateral calculi Complications Percutaneous nephrolithotomy PCNL |
| title | Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study |
| title_full | Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study |
| title_fullStr | Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study |
| title_full_unstemmed | Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study |
| title_short | Clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy (PCNL) in patients with kidney stones: A prospective cohort study |
| title_sort | clinical outcomes of the simultaneous bilateral percutaneous nephrolithotomy pcnl in patients with kidney stones a prospective cohort study |
| topic | Bilateral calculi Complications Percutaneous nephrolithotomy PCNL |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878033/ |
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