Percutaneous removal of the stones of the solitary kidney

Guliev B.G.

Aim: to evaluate the efficacy of the percutaneous nephrolithotripsy (PNL) in patients with the stones of the solitary kidney.

Materials and methods. PNL was performed in 48 patients with solitary kidney in the period from 2005 to 2014 years (group I). Control group (group II) consisted of the 56 patients with kidney stones from one side and contralateral healthy kidney. Overall groups contained 53 male (51,0%) and 51 female (49,0%) patients with the mean age of 50,8±12,6 years. Among the patients in the group I stones were located in pelvis in 60,4%, staghorn stones were present in 12,5% of patients, stones in pelvis and lower calyx in 10.4% and stones of the transplanted kidney in 4 patients (8,4%). In the group II 64,3% of patients had pelvis stones, 17,8% – staghorn stones and 7,1% – pelvis / lower calyx stones.

Results. Residual stones were evident in 10 patients (20,8%) in group I and in 8 patients (14,3%) in group II. e efficacy of PNL in group I was 79,2% and in group II – 85,7%. The most common complication in both groups was bleeding, necessitating hemotransfusion: 5 (10,4%) patients in group I and 5 (8,9%) patients in group II. Pleural injury with hydrothorax was revealed in one patient (1,8%) in the group II with the access in X intercostal space through the upper calyx. Loss of the punction channel and conversion were not evident in the group I. In the group II conversion was carried out in one patient (1,8%). The most common complication post-operatively was the activation of the chronic pyelonephritis: in 6 (12,5%) patients in group I and in 7 (14,3%) patients in group II. Urosepsis was evident only in 1 patients with staghorn stone (2,1%). Conclusions. PNL is a minimally invasive and effective treatment modality in patients with nephrolithiasis of the single kidney.

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