Login to Access Video or Poster Abstract: MP68-19
Sources of Funding: none

Introduction

We wanted to evaluate our outcomes of a single-session bilateral PCNL procedure during 16 years of practice.

Methods

Between 2000 and 2016, 85 patients underwent 89 bilateral Percutaneous Nephrolithotomy (PCNL) procedures. In this study we collected the epidemiological and clinical data of the patients and the intervention results. A successful treatment was defined as a stone free kidney or with a stone fragment of less than 5 mm and no need for an additional procedure within 1 year of initial treatment.

Results

Patients' age range was 1.5-87 years (mean 53.2, median 54), 42 women and 43 men. The mean and median hospitalization days ware 11. Seventeen patients (19%) were known to suffer from metabolic disorders. There was one patient with abnormal anatomy in both kidneys and five patients with abnormal anatomy in one kidney. The mean stone burden per kidney was 23 cm3 and the median was 8 cm 3. The mean and median operating time was 198 and 185 minutes respectively. Postoperative complications were noted in 64 patients divided by Clavien score: grade I - 20 % (13), grade II - 44% (28), grade III - 33% (21), grade IV - 0%, grade V - 3% (2). The most serious complications included: bleeding that required blood transfusion in 25% (21), pneumothorax that required drainage in 6% (5), pleural effusion that required drainage in 13% (11), sepsis 4.7% (4), two patients died during their hospital stay (one aged 74 had urosepsis, the other aged 88 died of pulmonary emboli). Overall, 75% of the operated kidneys, and 63% of the procedures achieved either a stone free state or insignificant stone without the need for further intervention.

Conclusions

Bilateral PCNL allows most patients with a very large stone burden to be fully treated in one session and achieve complete recovery. However, these procedures have a high rate of complications, including death. Therefore, patient selection and meticulous technique is of paramount importance.

Funding

none