Gigli F, Cerruto M A, Zattoni F
Urologia. 2008 Apr-Jun;75(1):108-12.
BACKGROUND. The management of bilateral renal stones still represents a therapeutic challenge and synchronous bilateral percutaneous nephrolithotomy (PCNL) appears to be a well tolerated, safe and relatively rapid procedure with a favorable cost-benefit ratio. The purpose of the present study is to report our experience in the synchronous percutaneous treatment of bilateral renal stones. METHODS. We retrospectively evaluated clinical files from 4 consecutive patients (BS, BE, OCB, FL), who underwent a synchronous bilateral PCNL, performed by the same operator (ZF), for the management of renal persistent and/or recurrent stones after extracorporeal shock wave lithotripsy, or other surgical maneuvers. From each patient's file we recorded a clinical history, any peri- and post-operative complication, any therapeutic resolution employed and the outcomes in terms of stones persistence/recurrence. RESULTS. Overall, 3 men (BS, BE, FL) and 1 woman (OCB), their age ranging from 31 up to 76 years, consecutively underwent synchronous bilateral PCNL. In 75% of cases a calcium- oxalate nephrolithiasis was found. We did not find any peri- or post-operative complication. All patients were stone-free after a mean follow-up of 12 months (range: 3-24 months). CONCLUSIONS. Synchronous bilateral PCNL is a relatively safe procedure; it may be performed in selected patients without increasing the morbidity of this surgical maneuver. The simultaneous treatment of the contra-lateral kidney may be taken into account only when the PCNL of the first side has been performed quickly and easily without any peri-operative complication.
背景。双侧肾结石的治疗仍然是一项治疗挑战，同期双侧经皮肾镜取石术（PCNL）似乎是一种耐受性良好、安全且相对快速的手术，具有良好的成本效益比。本研究的目的是报告我们在同期经皮治疗双侧肾结石方面的经验。方法。我们回顾性评估了4例连续患者（BS、BE、OCB、FL）的临床资料，这些患者由同一操作者（ZF）进行同期双侧PCNL，用于治疗体外冲击波碎石术或其他手术操作后残留和/或复发的肾结石。我们从每位患者的资料中记录了临床病史、任何围手术期和术后并发症、采用的任何治疗方法以及结石残留/复发方面的结果。结果。总体而言，3名男性（BS、BE、FL）和1名女性（OCB），年龄在31岁至76岁之间，连续接受了同期双侧PCNL。在75%的病例中发现了草酸钙肾结石。我们未发现任何围手术期或术后并发症。所有患者在平均随访12个月（范围：3 - 24个月）后结石清除。结论。同期双侧PCNL是一种相对安全的手术；可以在选定的患者中进行，而不会增加该手术操作的发病率。仅当第一侧的PCNL快速且顺利进行且无任何围手术期并发症时，才可以考虑同时治疗对侧肾脏。
