Introduction and Objectives
Unlike SWL or ureteroscopy, the percutaneous renal approach is not limited by stone size. However, the inherent complications of this technique, some of which really significant, necessitate a rigorous selection of the cases.
Material and Methods
Since introducing the percutaneous approach in our department in 2001, more than 2000 patients benefited from this surgical technique. With the continuously expanding experience, we approached more and more complex cases, with good results and a decreasing rate of complications. Among the 2103 patients with lithiasis, 174 presented bilateral disease. 6 patients were operated by single session percutaneous approach. The selection criteria for these patients consisted of lack of urinary infections, severe associated diseases (such as renal failure, diabetes, heart failure, coagulation problems, extreme obesity etc.). Patients’ choice was also decisive. The surgical procedure was continued on the contra-lateral renal unit only when the first intervention took place in good conditions, without complications.
Results
The hospital stay was 5±1 days, without major complications. After suppressing the nephrostomy tubes, 1 patient developed unilateral lumbar fistula, which necessitated ureteral stenting for 14 days. One patient presented upper urinary tract infection, which required antibiotherapy.
Conclusions
The renal percutaneous approach continues to remain an important alternative in the treatment of renal lithiasis, with no limitations related to stone size. Single session bilateral percutaneous nephrolithotomy may be used only in rigorously selected cases, in order to limit any eventual complications.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
