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Objective To discuss the safety and efficacy of simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) for bilateral renal or upper ureteral calculi. Methods Forty-eight cases (26 males, 22 females, 24-57 years )who underwent SBPCNL with pneumatic and ultrasonic power for bilateral renal or upper ureteral calculi were retrospectively reviewed. Clinical data including opera-tion time, blood loss, transfusion rates, length of hospital stay, stone free rate and complications were analyzed. Results The percutaneous renal access was successfully established under ultrasonic guid-ance in all patients. The average operation time was(105±18) rain(range 80-190 min). The average drop in hemoglobin was 21 g/L (range 5-54 g/L), with 5 patients requiring blood transfusion. In 43 patients, a single stage was performed on both sides, while 5 required the second stage PCNL on one side. A single tract was adopted on both sides in 44 patients, while 4 cases of the patients required two tracts on one side. No one required two tracts on both sides or more than one stage on both sides. The stone-clearance rate was 87.5 %. The average hospital stay was 6.5 d. There was no severe complica-tion occurred. Conclusion SBPCNL might be safe and effective for bilateral renal or upper ureteral calculi for selected patients.
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Objective To explore the safety of the elderly donors in living related donor kidney transplantation. Methods Forty-five elderly donors (51 - 78 years,study group) who underwent ne-phrectomy for living related donor kidney transplantation from April 1993 to December 2007 were retrospectively investigated. Clinical data including serum creatinine (SCr), glomerular filtration rate (GFR) in pre-and post-operation, operation complications and hospital stay time were analyzed and compared with the control group(62 cases, the donors age were younger than 50 years). Results The operations of all living donors were successful. The SCr and GFR in pre-operation were (82.16 ± 10.86)μmol/L, (85. 82±6.26)ml/min(study group)and (78. 66±10. 41)μmol/L, (88. 74±9. 44) ml/min (control group) respectively. There were no significant differences in SCr and GFR between the groups at different time points (P>0. 05). The average hospitalization time was 9 days in study group and 8 days in control group. There were no severe perioperative complications and no renal function failure was found in long-term following-up in study group. Conclusions Age is not the absolute contraindication of donor for living related donor kidney transplantation. The preoperative evaluation and careful operation can ensure the safety of elderly donors.
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Objective To report the experiertce of management of complicated renal stones by percu taneous nephrolithotripsy (PCNL) with pneumatic and ultrasonic power by ultrasound guidance. MethodsThree hundred and eighty two cases(218 males,164 females,4 74 years) who underwent PCNL by u sing the third generation Swiss LithoClast Master for kidney stones from 2004 to 2007 were retrospectivelyreviewed. Clinical data including operation time,stone free rate and complications were analyzed. ResultsPhaseⅠlithotripsy was performed in 397 sides and delayed phaseⅡlithotripsy in 8 sides. Twenty three casesunderwent simultaneous bilateral PCNL. The operation time ranged from 70 to 190 min,average time was(93±11)min. Nine cases needed blood transfusion. Severe complications did not occur during operations.Stone free rate was 91.8% (372/405). Residual stone fragment was found in 33 cases after delayed phase Ⅱlithotripsy and 14 cases received adjuvant extracorporeal shock wave lithotripsy. One hundred and forty sixcases were followed up for 3 to 24 months and showed no recurrence. Conclusion PCNL with pneumaticand ultrasonic power could be an efficient treatment for complicated kidney stones.