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Erschienen in: World Journal of Urology 5/2019

25.09.2018 | Original Article

Long-term outcomes of ultrasound-guided percutaneous nephrolithotomy in patients with solitary kidneys: a single-center experience

verfasst von: Boxing Su, Wenyi Liang, Weiguo Hu, Bo Xiao, Xin Zhang, Song Chen, Yuzhe Tang, Yubao Liu, Meng Fu, Wenjie Bai, Jianxing Li

Erschienen in: World Journal of Urology | Ausgabe 5/2019

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Abstract

Purpose

To report our experience with total ultrasound-guided percutaneous nephrolithotomy (PCNL) in the management of patients with solitary kidney, and evaluate the safety and feasibility of this technique.

Materials and methods

Between October 2014 and December 2016, 48 patients with solitary kidneys underwent total ultrasound-guided PCNL at our institution. Stone-free rate (SFR), auxiliary procedures, and complications were recorded. Changes in renal function were evaluated by comparing preoperative and postoperative estimated glomerular filtration rates (eGFRs). Perioperative factors that may affect renal function were analyzed to define factors predicting renal function improvement on long-term follow-up. Of 48 patients, 44 were followed at least 6 months, whereas four patients were lost to follow-up.

Results

Among all patients, staghorn calculi were found in 18 (37.5%) patients. 14 (29.2%) patients required a two-stage PCNL. Struvite was found in six (12.5%) patients. Complications were reported in eight (16.7%) patients. Severe bleeding was noticed in three patients; no angioembolization was required. After a median follow-up of 12 (6–26) months, the final SFR was 81.8% after auxiliary treatments. There was a significant improvement of eGFR from 53.9 ± 24.0 to 61.3 ± 25.4 mL/min/1.73 m2 (P < 0.01). Renal function was stable, improved and worse in 65.9% (n = 29), 27.3% (n = 12), and 6.8% (n = 3) of patients, respectively, compared with preoperative levels.

Conclusions

Ultrasound-guided PCNL is a safe and feasible procedure with an acceptably low complication rate in patients with solitary kidneys. At long-term follow-up, the renal function in more than 90% of the patients with solitary kidneys can be improved or stabilized after ultrasound-guided PCNL.
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Metadaten
Titel
Long-term outcomes of ultrasound-guided percutaneous nephrolithotomy in patients with solitary kidneys: a single-center experience
verfasst von
Boxing Su
Wenyi Liang
Weiguo Hu
Bo Xiao
Xin Zhang
Song Chen
Yuzhe Tang
Yubao Liu
Meng Fu
Wenjie Bai
Jianxing Li
Publikationsdatum
25.09.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 5/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2458-5

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