Patients with autosomal dominant polycystic kidney disease (ADPKD) showed relatively high incidence of urinary stones. Enlarged kidneys occupied by cysts could make the stone-removal surgery relatively difficult. This study aimed to compare the efficacy and safety of retroperitoneal laparoscopic ureterolithotomy (RPLU), flexible ureteroscopic lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) in the ADPKD patients with upper urinary stones.
In this study, 45 patients with ADPKD who underwent RPLU, FURL and PCNL procedures were evaluated. Demographic and serum parameters, stone features, outcomes and complications were analyzed.
45 patients were included in the present study, 13 received RPLU, 21 received FURL, and 11 received PCNL. There were no significant differences in demographic and serum parameters between the three groups. Stone-free rates of the three approaches are 100%, 85.7% and 90.9%, respectively. Patients who underwent FURL had shorter mean operative time and postoperative hospital stay. Compared to RPLU and PCNL, FURL resulted in fewer complications, but the difference is statistically non-significant.
RPLU, FURL and PCNL are commonly used surgical methods to solve upper urinary calculi in ADPKD patients and could achieve satisfactory stone clearance. Among them, FURL showed a relative high safety and faster recovery.
Clinical and experimental nephrology. 2020 May 08 [Epub ahead of print]
Yuchen Xu, Zhengming Bai, Dongyue Ma, Qingsong Niu, Binbin Gong, Jun Zhou, Jianzhong Wang, Zongyao Hao, Chaozhao Liang
Department of Urology, the First Affiliated Hospital of Anhui Medical University, Jixi Road #218, Hefei, Anhui, 230022, P.R. China., Institute of Urology, Anhui Medical University, Hefei, China., Department of Urology, the First Affiliated Hospital of Anhui Medical University, Jixi Road #218, Hefei, Anhui, 230022, P.R. China. ., Department of Urology, the First Affiliated Hospital of Anhui Medical University, Jixi Road #218, Hefei, Anhui, 230022, P.R. China. .