Objective: Asynchronous Bilateral percutaneous nephrolithotomy (PCNL) is a challenging technique, underdiscussed within the current clinical practice. We aimed to quantify the postoperative outcomes of this technique within our institutional database.
\nMethods: We relied on a single-centre retrospective database including 658 patients who underwent endourological surgeries for stone treatment, between 2018 and 2025. Postoperative outcomes, namely postoperative complications, length of stay (LOS), stone-free rates (SFR) and renal function were quantified. SFR was defined at 3-months after procedure as residual stones of \u2264 2mm.
\nResults: Based on a median follow-up of 24 months (interquartile range [IQR]: 12, 44 months), 11 asynchronous bilateral PCNL were performed.
\nOf those, two (18%) were bilateral mini-ECIRS and six (55%) patients harbored a staghorn calculus. Median age of the treated population was 66 years (IQR: 48, 71) and median body mass index (BMI) was 24 (IQR 22, 27).
\nOut of all 11 surgeries, three (27%) were performed in patients with chronic kidney disease (CKD) stage III.
\nMoreover, six (55%) surgeries were performed in Guy\u2019s stone score (GSS) = IV stones.
\nMedian volume of bilateral stones was 27 mm3 (IQR: 17, 462mm3) with a median Hounsfield Unit of 1,542 (IQR: 1,173, 1,643).
\nAmong 11 surgeries, six (55%) were pre-stented with nephrostomy tube, double J stent or both. According to postoperative outcomes, no major overall complications, defined as CD >2, were recorded, and median LOS was 4 days (IQR: 3, 5 days). One patient (9%) was readmitted for uncontrolled colic pain. Median indwelling nephrostomy tube time was 2 days (IQR: 2, 2) while 21 days (IQR: 14, 28) for double J stent. According to renal function, median preoperative eGFR function was 95 (IQR: 64, 100), while eGFR at 12-mo was 89 (61, 91). No differences were recorded between pre-operative and 3-mo eGFR (p= 0.2) or 6-mo eGFR (p= 0.2) or 12-mo eGFR (p= 0.2). The SFR was 55%. It was assessed using ultrasonography and abdominal X-ray in six patients, CT scan in three patients (27%), ultrasonography alone in one patient (9%), and abdominal X-ray alone in one patient (9%). Timing for assessing SFR was one month in nine (82%) patients and two-months in two (18%) patients. Specifically, for four patients an adjuvant treatment, namely extracorporeal shock wave lithotripsy (one, 9%), PCNL (one, 9%), and second-look ureteroscopy (two, 18%), was performed. Finally, nine of eleven (82%) of patients in whom crystallographic exam was performed, first stone components were uric acid (n=3, 33%), mono-hydrate oxalate (n=2, 22%), di-hydrate oxalate (n=2, 22%), others (n=2; 22%).
\nConclusions: In this single-center European cohort, bilateral PCNL was a safe treatment option for patients harboring high-volume kidney stones. The procedure was associated with an acceptable SFR, comparing with the preoperative kidney stones volume (>10mL), and optimal eGFR function, ensuring its feasibility in this complex clinical scenario<\/p>\n","protected":false},"excerpt":{"rendered":"
Objective: Asynchronous Bilateral percutaneous nephrolithotomy (PCNL) is a challenging technique, underdiscussed within the current clinical practice. We aimed to quantify the postoperative outcomes of this technique within our institutional database. Methods: We relied on a single-centre retrospective database including 658 … read more<\/a><\/p>","protected":false},"author":3,"featured_media":179,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-178","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/179"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=178"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=178"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}