Bilateral simultaneous percutaneous nephrolithotomy versus staged approach: a critical analysis of complications and renal function

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTORRICELLI, Fabio C. M.
dc.contributor.authorCARVALHO, Regina S.
dc.contributor.authorMARCHINI, Giovanni S.
dc.contributor.authorDANILOVIC, Alexandre
dc.contributor.authorVICENTINI, Fabio C.
dc.contributor.authorBATAGELLO, Carlos A.
dc.contributor.authorSROUGI, Miguel
dc.contributor.authorNAHAS, William C.
dc.contributor.authorMAZZUCCHI, Eduardo
dc.date.accessioned2021-02-18T13:25:17Z
dc.date.available2021-02-18T13:25:17Z
dc.date.issued2020
dc.description.abstractINTRODUCTION: Patients with bilateral kidney stones and burdened by large stones are challenging cases for endourologists. Simultaneous bilateral percutaneous nephrolithotomy (sbPCNL) is an option; however, it may be accompanied by important morbidity. An alternative is a staged PCNL, operating one side each time. Herein, we compare the impact of sbPCNL and staged PCNL on complication rates and renal function. METHODS: Patients who underwent sbPCNL or staged bilateral PCNL with a frame time of 6 months were searched in our prospectively collected kidney stone database. Groups were compared for age, gender, body mass index (BMI), comorbidities (classification by the American Society of Anesthesiology - ASA), stone size, Guy's score, stone-free status, renal function, blood loss, blood transfusion rate, complication rate, and length of hospital stay. RESULTS: Twenty-six patients and 52 kidney units were enrolled. The mean operative time was 134.7 min. Only 11.3% of cases had complications, all of them minor (Clavien <= 2). Overall, the stone-free rate was 61.50%. Comparing the groups, there was a significantly longer operative time in the sbPCNL group (172.5 vs. 126.3 min; p=0.016), as well as a higher transfusion rate (12.5% vs. 5.6%; p=0.036). There was no statistically significant difference in creatinine levels between the groups. Regarding the stone-free rate, there was a significantly higher proportion of patients in the staged PCNL group (64.9% vs. 43.8%; p=0.012). CONCLUSION: sbPCNL is a safe procedure; however, when compared to staged procedures it has a higher transfusion and lower stonefree rate.eng
dc.description.indexMEDLINEeng
dc.identifier.citationREVISTA DA ASSOCIACAO MEDICA BRASILEIRA, v.66, n.12, p.1696-1701, 2020
dc.identifier.doi10.1590/1806-9282.66.12.1696
dc.identifier.eissn1806-9282
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/38985
dc.language.isoeng
dc.publisherASSOC MEDICA BRASILEIRAeng
dc.relation.ispartofRevista da Associacao Medica Brasileira
dc.rightsopenAccesseng
dc.rights.holderCopyright ASSOC MEDICA BRASILEIRAeng
dc.subjectComplicationseng
dc.subjectKidneyeng
dc.subjectLithotripsyeng
dc.subjectUrinary calculieng
dc.subject.otherstone diseaseeng
dc.subject.otherkidney-stoneseng
dc.subject.otherguidelineseng
dc.subject.othermanagementeng
dc.subject.otherefficacyeng
dc.subject.othersafetyeng
dc.subject.otherriskeng
dc.subject.wosMedicine, General & Internaleng
dc.titleBilateral simultaneous percutaneous nephrolithotomy versus staged approach: a critical analysis of complications and renal functioneng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalCARVALHO, Regina S.:Fac Amer, Sao Paulo, SP, Brazil
hcfmusp.citation.scopus3
hcfmusp.contributor.author-fmusphcFABIO CESAR MIRANDA TORRICELLI
hcfmusp.contributor.author-fmusphcGIOVANNI SCALA MARCHINI
hcfmusp.contributor.author-fmusphcALEXANDRE DANILOVIC
hcfmusp.contributor.author-fmusphcFABIO CARVALHO VICENTINI
hcfmusp.contributor.author-fmusphcCARLOS ALFREDO BATAGELLO
hcfmusp.contributor.author-fmusphcMIGUEL SROUGI
hcfmusp.contributor.author-fmusphcWILLIAM CARLOS NAHAS
hcfmusp.contributor.author-fmusphcEDUARDO MAZZUCCHI
hcfmusp.description.beginpage1696
hcfmusp.description.endpage1701
hcfmusp.description.issue12
hcfmusp.description.volume66
hcfmusp.origemWOS
hcfmusp.origem.pubmed33331579
hcfmusp.origem.scieloSCIELO:S0104-42302020001201696
hcfmusp.origem.scopus2-s2.0-85098607423
hcfmusp.origem.wosWOS:000599837000018
hcfmusp.publisher.citySAO PAULOeng
hcfmusp.publisher.countryBRAZILeng
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Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/55