Сравнительный анализ результатов оперативного лечения пациентов с двусторонним нефролитиазом методом одновременной билатеральной и этапной мини-перкутанной нефролитотомии в положении на спине

Abstract

To evaluate feasibility and efficiency of simultaneous bilateral supine mini-percutaneous nephrolithotomy in patients with bilateral kidney stones. 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. 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 didnt 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. Our study demonstrates that simultaneous bilateral mini-percutaneous nephrolithotomy is a safe and effective treatment option for patients with bilateral kidney stones.