PERCUTANEOUS NEPHROLITHOTOMY: A MINIMAL INVASIVE SURGICAL OPTION FOR THE TREATMENT OF STAGHORN RENAL CALCULI

Main Article Content

Anayat Ullah
Muhammad Kamran Khan
Ata Ur Rahman
Riaz Ur Rehman

Abstract

Objectives: To see the safety and efficacy of percutaneous nephrolithotomy (PCNL) for the treatment of staghorn renal stone.

Methodology: This descriptive study was conducted in Department of Urology and Renal Transplantation, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar, Pakistan from June 2010 to May 2012. A total of 52 patients who underwent PCNL for staghorn renal stones irrespective of the age and gender were selected for this study through the technique of non-probability consecutive sampling. All the procedures were carried out by a single surgeon, under general anesthesia and in prone position. Data was analyzed on a computer using SPSS version 10 for windows XP.

Results: Mean age was 35.9±14.5 years (range 7-59 yrs). The average procedure time was 105±19.3 minutes (range 75–180 minutes). The mean size of the stone was 3.9±1.2 cm (range 3.1-5.8 cm). In 41 of 52 (78.84%) patients, complete stone clearance was achieved after a single session of PCNL. The procedure was staged in 04 (7.7%) patients and a repeat PCNL was performed. Complete clearance (including second stage PCNL) was achieved in 44 of 52 (84.61%) patients. With dual therapy (PCNL + shock wave lithotripsy), stone clearance was achieved in 48 of 52 (92.3%) patients. The commonest complication encountered was bleeding in 4/52 (7.7%) patients necessitating blood transfusion. The mean hospital stay was 3±0.9 days and nephrostomy tube was kept for 2 days.

Conclusion: PCNL is safe and effective treatment for staghorn renal calculi associated with less morbidity and shorter hospital stay.

Key Words: Staghorn stone, Percutaneous Nephrolithotomy (PCNL), Efficacy.

 

This article may be cited as: Ullah A, Khan MK, Rahman AU, Rehman RU. Percutaneous nephrolithotomy: A minimal invasive surgical option for the treatment of staghorn renal calculi. Khyber Med Univ J 2012; 4(4): 156-160.

Article Details

How to Cite
Ullah, Anayat, et al. “PERCUTANEOUS NEPHROLITHOTOMY: A MINIMAL INVASIVE SURGICAL OPTION FOR THE TREATMENT OF STAGHORN RENAL CALCULI”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 4, no. 4, Dec. 2012, pp. 156-60, https://www.kmuj.kmu.edu.pk/article/view/11124.
Section
Original Articles

References

Husain M, Rizvi SAH, Askari H, Sultan G, Lal M. Management

of stone diseases: 17 years experience of stone clinic in a developing country. J Pak Med Assoc 2009;29(12):843-6.

Saussine C, Lechevallier E, Traxer O. Staghorn or

complex calculi: medical considerations. Prog Urol

;18(12):963-5.

Kuzgunbay B, Turunc T, Yaycioglu O, Kayis AA, Gul U,

Egilmez T, et al. Percutaneous nephrolithotomy for staghorn

kidney stones in elderly patients. J Urol Nephrol.

;43(3):639-43.

Blandy JP, Singh M. The case for a more aggressive

approach to staghorn stones. J Urol 1976;115:505–6.

Resorlu B, Kara C, Oguz U, Bayindir M, Unsal A. Percutaneous nephrolithotomy for complex caliceal and

staghorn stones in patients with solitary kidney. Urol

Res. 2011;39(3):171-6.

Lahme S, Bichler KH, Strohmaier WL, Gotz T. Minimally

invasive PCNL in patients with renal pelvic and calyceal

stones. Eur Urol 2001;40:619-24.

Al-Kohlany KM, Shokeir AA, Mosbah A, Mohsin T, Shoma

AM, Eraki I et al. Treatment of complete staghorn

stones: A prospective randomized comparison of open

surgery versus percutaneous nephrolithotomy. J Urol

;173(2):469-73.

Preminger GM, Assimos DG, Lingeman JE, Nakada SY,

Pearle MS, Wolfe JS. AUA Nephrolithiasis Guideline Panel.

Chapter 1: AUA guideline on management of staghorn

calculi: Diagnosis and treatment recommendations. J

Urol 2005;173:1991–2000.

Saucy F, Duvdevani M, Nott L, Denstedt JD, Helmbold

P, Caniatti M et al. Percutaneous Nephrolithotomy for

Staghorn Calculi: A Single Center’s Experience over 15

Years. J Endourology 2009;23(10): 1669-73.

Netto RN, Claro JF, Ferreira U: Is percutaneous monotherapy for staghorn calculous still indicated in the era

of extracorporeal shock wave lithotripsy? J Endourol

,8:195-197.

Razvi H, Denstedt JD, Sosa RE, Vaughan ED Jr: Endoscopic lithotripsy devices. AUA update series 1995,

(lesson 14):290-6.

Lingeman JE, Lifshitz DA, Evan AP: Surgical management

of urinary lithiasis. In Campbell’s Urology Edited

by: Walsh PC, Retik AB,Vaughan EDJ. W. B. Saunders

company: Philadelphia; 2002:3361-3451.

Ziaee SA, Sichani MM, Kashi AH, Samzadeh M. Evaluation

of the learning curve for percutaneous nephrolithotomy.

Urol J 2010;7(4):226-31.

Singla M, Srivastava A, Kapoor R, Gupta N, Ansari MS,

Dubey D, Kumar A: Aggressive approach to staghorn

calculi-safety and efficacy of multiple tracts percutaneous

nephrolithotomy. Urology 2008, 71(6):1039-42.

Holman E, Khan AM, Pasztor I, Toth C: Simultaneous

bilateral compared with unilateral percutaneous nephrolithotomy. BJU Int 2002, 89(4):334-8.

Jou YC, Cheng MC, Lin CT, Chen PC, Shen JH: Nephrostomy tube-free percutaneous nephrolithotomy for

patients with large stones and staghorn stones. Urology

, 67(1):30-4.

El-Nahas AR, Eraky I, Shokeir AA, Shoma AM, el-Assmy

AM, el-Tabey NA et al. Factors affecting stone-free rate

and complications of percutaneous nephrolithotomy for

treatment of staghorn stone. J Urology 2012;79(6):1236-

Manohar T, Ganpule AP, Shrivastav P, Desai M. Percutaneous nephrolithotomy for complex caliceal calculi and

staghorn stones in children less than 5 years of age. J

Endourol 2006;20(8):547-51.

Davol PE, Wood C, Fulmer B. Success in treating renal calculi with single-access, single-event percutaneous

nephrolithotomy: is a routine “second look” necessary?

J Endourol 2006;20(5):289-92.

Gleeson MJ, Griffith DP: Extracorporeal shock wave

lithotripsy monotherapy for large renal calculi. Br J Urol

;64:329.

Kurtulus F, Fazlioglu A, Tandogdu Z, Karaca S, Salman

Y, Cek M. Analysis of factors related with bleeding in

percutaneous nephrolithotomy using balloon dilatation.

Canadian J Urol 2010;17(6):5483-9.