Bansal Punit, Bansal Neeru, Sehgal Anand, Singla Subhash
Department of Urology, RG Stone and Super Speciality Hospital, Ludhiana, Punjab, India.
Department of Pulmonary Medicine, CMC and H, Ludhiana, Punjab, India.
Urol Ann. 2016 Jan-Mar;8(1):56-9. doi: 10.4103/0974-7796.163793.
Assessment of treatment outcomes in patients undergoing bilateral single-session retrograde intra-renal surgery (RIRS) for bilateral renal stones up to 1.5 cm.
Retrospective analysis of 74 patients was done with bilateral renal calculi, who underwent bilateral single-session RIRS at our stone referral hospital from December 2011 to May 2014. The selection criteria for this intervention were patient's preference, failure of other treatments and stone up to 1.5 cm. Patients with creatinine more than 2, pyonephrosis sepsis, bilateral impacted pelviureteric junction calculi were excluded from study. All patients were evaluated with serum biochemistry, urinalysis, urine culture, plain radiography of kidney-ureter-bladder, intravenous urography, renal ultrasonography (USG) and/or computed tomography (CT). Follow-up evaluation included serum biochemistry and postoperative plain film and renal USG. The success rate was defined as patients who were stone-free or only had a residual fragment of less than 4 mm. CT was conducted only in patients with residual stones, which were present in seven patients.
A total of 74 patients (50 male, 24 female) with a mean age 39.2 ± 15.2 were included in the present study. The mean stone size was 11.7 ± 2.4 mm. The stone-free rates were 86.84% and 97.29% after the first and second procedures, respectively. In eight patients (10.8%), minor complications were observed, whereas no major complications were noted in the studied group. There was no significant difference in pre- and post-operative serum creatinine levels.
In patients with bilateral renal stones up to 1.5 cm bilateral single-session RIRS with flexible ureteroscope can be safely performed with low complication rate.
评估接受双侧单次逆行性肾内手术(RIRS)治疗直径达1.5厘米双侧肾结石患者的治疗效果。
对2011年12月至2014年5月期间在我院结石转诊中心接受双侧单次RIRS的74例双侧肾结石患者进行回顾性分析。该干预措施的选择标准为患者偏好、其他治疗失败以及结石直径达1.5厘米。肌酐超过2、肾盂积脓败血症、双侧肾盂输尿管连接部嵌顿结石患者被排除在研究之外。所有患者均接受血清生化、尿液分析、尿培养、肾脏输尿管膀胱平片、静脉肾盂造影、肾脏超声检查(USG)和/或计算机断层扫描(CT)评估。随访评估包括血清生化以及术后平片和肾脏USG。成功率定义为结石清除或仅残留小于4毫米碎片的患者。仅对7例有残留结石的患者进行了CT检查。
本研究共纳入74例患者(男性50例,女性24例),平均年龄39.2±15.2岁。平均结石大小为11.7±2.4毫米。首次和第二次手术后的结石清除率分别为86.84%和97.29%。8例患者(10.8%)出现轻微并发症,而研究组未观察到重大并发症。术前和术后血清肌酐水平无显著差异。
对于直径达1.5厘米的双侧肾结石患者,使用软性输尿管镜进行双侧单次RIRS可安全实施,并发症发生率低。