Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Beijing, China.
Urol Int. 2024;108(3):190-197. doi: 10.1159/000536545. Epub 2024 Jan 30.
We explored the viability of simultaneous bilateral endoscopic surgery (SBES) in the prone split-leg position for managing bilateral calculi.
We retrospectively reviewed 72 patients who underwent SBES, with procedures involving ureteroscopy (URS) and contralateral percutaneous nephrolithotomy (PNL) simultaneously, in prone split-leg position.
Operative times averaged 109.38 ± 30.76 min, with an average hospital stay of 7.79 ± 3.78 days. The bilateral stone-free rate (SFR) was 70.83%, while URS and PNL demonstrated comparable unilateral SFR (83.33% and 79.17%, respectively). Receiver operating characteristics curves for predicting unilateral residual fragments yielded an area under the curve of 0.84 (URS) and 0.81 (PNL) with respective cutoff values of stone diameter of 11.55 mm and 23.52 mm. Fifty-seven (79.17%) and 15 (20.83%) patients encountered grade 0-1/2 complications, with no severe complications (grade 3-5) recorded. No significant changes in blood count or renal function were observed post-SBES.
SBES in the prone split-leg position is a viable option for managing bilateral upper tract urolithiasis. Larger scale studies are needed to further assess safety and efficacy in various positions.
我们探索了在俯卧分腿位同时行双侧内镜手术（SBES）治疗双侧结石的可行性。
我们回顾性分析了 72 例接受 SBES 的患者，这些患者均在俯卧分腿位下同时行输尿管镜检查（URS）和对侧经皮肾镜取石术（PCNL）。
手术时间平均为 109.38 ± 30.76 分钟，平均住院时间为 7.79 ± 3.78 天。双侧结石清除率（SFR）为 70.83%，而 URS 和 PNL 的单侧 SFR 相当（分别为 83.33%和 79.17%）。预测单侧残余结石的受试者工作特征曲线得出 URS 和 PNL 的曲线下面积分别为 0.84 和 0.81，各自的截断值为结石直径 11.55mm 和 23.52mm。57 例（79.17%）和 15 例（20.83%）患者出现 0-1/2 级并发症，无严重并发症（3-5 级）。SBES 后血计数或肾功能无明显变化。
俯卧分腿位 SBES 是治疗双侧上尿路结石的一种可行选择。需要更大规模的研究来进一步评估在不同体位下的安全性和疗效。
