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Efficacy of Simultaneous Bilateral Surgery Using the Oblique Overriding Position in the Treatment of Bilateral Kidney Stones.

Ranxing Yang,Meng Liu,Wang Li, Yanduo Lin, Hui Guo,Ying Wang, Rong Chen,Qiang Fu

Urolithiasis(2023)

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摘要
To compare the safety and the efficacy of simultaneous bilateral surgery in the oblique overriding position versus staging surgery in the treatment of bilateral renal calculi. A total of 46 patients with bilateral renal stones from May 2019 to January 2022 in our center were retrospectively analyzed, including 29 males and 17 females, with a mean age of 48 ± 13.6 years, body mass index of 24.6 ± 2.3 kg/m 2 , and uneven size of bilateral renal stones, with a mean diameter of 29.5 ± 9.1 mm on the side with the larger kidney stones (PCNL) and a mean diameter of 13.1 ± 3.2 mm on the side with the smaller kidney stones. The patients were divided into two groups for simultaneous and stepwise bilateral endoscopic surgery, and the operative time, anesthesia time, postoperative hemoglobin, blood creatinine, postoperative VAS pain score, Clavien complication rating, average hospital stay, and stone removal rate at one month after surgery were evaluated in both groups. The simultaneous group outperformed the other group in anesthesia time, operative time, VAS score, and mean number of days in the hospital, and there were no significant differences between the two groups in postoperative hemoglobin drop values, hematocrit elevation values, Clavien complication ratings, and stone clearance rate at one month. Both simultaneous surgery and staging surgery were safe and effective. Simultaneous surgery can effectively shorten the operation and anesthesia time, and reduce the postoperative pain and hospital days of patients while ensuring similar stone clearance rates.
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关键词
Kidney stones,Percutaneous nephrolithotomy,Flexible ureteroscopy,Simultaneous bilateral surgery,Oblique overriding position
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