AI Article Synopsis
- Advances in endourology have reduced the need for open surgery to treat staghorn calculi, but this study highlights cases where open surgery remains effective.
- A cohort of 26 patients underwent anatrophic nephrolithotomy, with an average stone size of 68.5mm and a stone-free rate of 92%.
- Despite advances in methods, the results indicate that open surgery still offers beneficial outcomes in terms of stone removal and kidney preservation, although the technique is becoming less emphasized in training.
Article Abstract
Purpose: Advances in endourology have significantly reduced indications of open surgery in the treatment of staghorn calculi. However, in our experience, open surgery is still the treatment of choice in some cases. This study presents the results of a series of selected patients and discusses the results in terms of efficacy and morbidity.
Materials: A cohort of 26 patients underwent anatrophic nephrolithotomy by lombotomy to treat a complex staghorn calculus.
Results: The mean stone size was 68,5mm, 70% were complete staghorn calculi. The operative time was 100minutes. Blood loss was 225mL, with a postoperative transfusion rate of 15.4%. The hospital stay was 8.4 days. The stone free rate following the procedure was 92%. The creatinine clearance (MDRD) at 3 months was improved from 5.9mL/min/m(2) on average over the entire series.
Conclusion: There are clearly still indications for open surgery in staghorn stones management, with good results in this contemporary series on both stone removal and nephronic preservation. Yet, it appears that this technique is no longer taught.
Level Of Evidence: 5.
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| http://dx.doi.org/10.1016/j.purol.2014.09.050 | DOI Listing |
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