Abstract
A retrospective review was conducted to evaluate intraoperative and patient outcomes following simultaneous bilateral percutaneous nephrolithotomy (SB-PCNL). Target stone characteristics, operative time, hospitalization length, post-operative complications, blood loss, opioid use, pain, and stone-free rates were evaluated. In total, 42 patients with large renal stones (>20 mm2) were identified for this study, and 38% of them achieved stone-free status with no residual fragments apparent on post-operative day one CT imaging. The maximum mean residual fragment size was 3.67 mm2 and average number of residual fragments following the procedures was 1.63. The rates of blood loss, post-operative complications, opioid use, and pain from the study cohort were similar to the reported outcomes of studies conducted by others. The potential benefits of a single procedure and anesthesia to treat bilateral stone burdens, lower total pain medication prescribed, and lower hospital costs render SB-PCNL as an attractive option in the treatment of bilateral kidney stones.
Highlights
Simultaneous Bilateral PercutaneousUrolithiasis poses a significant healthcare burden amongst the working-age population, with prevalence and incidence rates increasing globally
simultaneous bilateral percutaneous nephrolithotomy (SB-percutaneous nephrolithotomy (PCNL)) in one surgical session rather than coming back for two surgeries. In this retrospective cohort study, we aimed to investigate the safety and efficacy of SB-PCNL
Our study suggests that simultaneous bilateral PCNL (SBPCNL) is safe and efficacious for patients requiring surgical management of large bilateral stones
Summary
Simultaneous Bilateral PercutaneousUrolithiasis poses a significant healthcare burden amongst the working-age population, with prevalence and incidence rates increasing globally. Not all kidney stone episodes require treatment, surgical intervention is warranted if stones are symptomatic, associated with obstruction or infection, or pose a threat to renal function [3]. 20 mm on cross sectional imaging, percutaneous nephrolithotomy (PCNL) is the goldstandard surgical intervention recommended by the American Urological Association [4]. This procedure has demonstrated the highest stone-free rate for larger stones when compared to other endourological modalities [3]. PCNL accounts for only 5% of all stone-related procedures This is in large part due its invasive nature, higher complication rates, and more technical demands compared to ureteroscopy or extracorporeal shockwave lithotripsy [5,6]. For patients requiring bilateral PCNL procedures, complications are an even greater concern [7]
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