Modern tactics of management of patients with bilateral staghorn nephrolithiasis


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Resumo

A comparative analysis of the effectiveness of open and percutaneous operations in the treatment of bilateral staghorn nephrolithiasis (SN) was performed. Of the 38 patients with bilateral SN, stage operation (without discharge) was performed in 26 (68,5%) patients, and single-step operation — in 12 (31,5%) patients. For the 47 patients with bilateral SN, who underwent open surgery, the interventions were following: pelviolithotomy (64 operations), nephrolithotomy (21 operations), nephrectomy (9 operations). Surgery was performed in stages on each side, but unlike percutaneous operations, with discharge from the hospital. When using open surgery, only in 27 of the 47 patients complete discharge of kidney stones was achieved. A comparative analysis of single-step and stage surgery for bilateral SN revealed no significant difference in the duration of surgery and intraoperative blood loss (p>0,1); endoscopic surgery compared with open surgery is characterized by significantly lower intraoperative blood loss and postoperative in-hospital stay (p<0,001).

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Bibliografia

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