Особенности перкутанной хирургии билатерального коралловидного нефролитиаза
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Abstract:
Between 2009 and 2012, we examined and treated 38 patients with bilateral kidney stones. In all 38 patients, stones were removed by percutaneous nephrolithotripsy (PCNL). Out of 38 patients with bilateral staghorn kidney stones, 26 patients (68.5%) had separate surgeries on either kidney, 9 patients (23.7%) had one-step surgery, and 3 patients (7.8%) had PCNL on one kidney and percutaneous nephrostomy (PCN) on the other. Out of 9 patients who had one-step surgery, PCNL allowed for a complete removal of stones from both kidneys in 4 patients and a removal of stones from one kidney in 3 patients. The other 5 patients had bilateral residual kidney stones after PCNL. For these 5 patients, the second step of treatment included stone extraction, which was done through a fistula and allowed for a complete removal of calculi in 1 patient. For the other 4 patients, stone extraction through a fistula was repeated, allowing for a complete removal of stones in 2 patients. Out of 26 patients with bilateral staghorn kidney stones who had a separate stone-removal surgery on either kidney, 9 patients had all stones removed from one kidney after PCNL, in seven patients the kidney was stone-free when stones were extracted through a fistula. As for surgery for the second kidney, PCNL allowed for a complete removal of stones in 10 patients, and extraction of stones through a fistula in 12 patients. When indicated, one-step bilateral nephrolithotripsy is an effective treatment option for patients with bilateral staghorn kidney stones.Keywords:
Nephrostomy
Percutaneous nephrostomy
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