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Minerva Urologica e Nefrologica 2017 October;69(5):432-45

DOI: 10.23736/S0393-2249.17.02831-4


lingua: Inglese

Bilateral endoscopic surgery for renal stones: a systematic review of the literature

Silvia PROIETTI 1 , Jean de la ROSETTE 2, Brian EISNER 3, Franco GABOARDI 1, Cristian FIORI 4, Ella KINZIKEEVA 1, Lorenzo LUCIANI 5, Roberto MIANO 6, Francesco PORPIGLIA 4, Marco ROSSO 1, Mario SOFER 7, Olivier TRAXER 8, Guido GIUSTI 1

1 Department of Urology, San Raffaele Turro, Milan, Italy; 2 Department of Urology, AMC University Hospital, Amsterdam, The Netherlands; 3 Department of Urology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; 4 Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy; 5 Department of Urology, Santa Chiara Hospital, Trento, Italy; 6 Urology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy; 7 Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; 8 Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France


INTRODUCTION: The aim of this study was to evaluate the current literature on single-session bilateral endoscopic surgery for renal stones, analyzing their effectiveness and safety.
EVIDENCE ACQUISITION: A systematic literature review was performed to identify articles published between 1995 and July 2016 that reported data on bilateral single-session endoscopic surgery for renal stones. Articles were separated into the following categories: bilateral PCNL, bilateral FURS and bilateral PCNL with contralateral FURS. We used a narrative synthesis for the analyses of the studies.
EVIDENCE SYNTESIS: Five reports of bilateral FURS were identified in the literature search. These studies included a total of 218 patients that underwent bilateral FURS for renal stones. The primary SFR ranged from 64% to 92.8%. Postoperative complications were mostly described as minor complications; one major complication (0.5%) (grade V) was reported. Thirteen reports of bilateral PCNL were identified. These case studies included a total of 729 patients undergoing bilateral PCNL for renal stones. The primary SFR ranged from 24% to 100%. In all the studies a total of 29 (4%) major complications were described: 28 of them grade III while one was grade IV. One single study of bilateral PCNL with contralateral FURS for renal stones was identified. This report included 26 patients and the primary SFR was 92.3%. Two major complications (7.7%) (Grade III) were described.
CONCLUSIONS: Bilateral single-session endoscopic procedures for bilateral renal stones are effective and safe. It should be considered a viable treatment option in carefully selected patients, performed by experienced urologists in high-volume centers. Key to success is the proper selection of patients and extending surgery on the second side only when the first side has been uneventful.

KEY WORDS: Ureteroscopy - Nephrostomy, percutaneous - Kidney calculi

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