Open stone surgery: Is it still a preferable procedure in the management of staghorn calculi?
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We reviewed 43 patients with staghorn calculi to determine the effectiveness of various treatment modalities such as extracorporeal shock wave lithotripsy (ESWL) monotherapy, ESWL and percutaneous nephrolithotomy (PCNL) combined therapy, and open stone surgery.
While ESWL monotherapy and ESWL+PCNL were performed in 25 and 8 patients, respectively, 10 patients underwent open stone surgery. Of the 25 patients treated with ESWL, 8 were stone-free, whereas 4 out of 8 patients treated with ESWL+PCNL and 8 out of 10 patients treated with open surgery were stone-free. The complications of ESWL monotherapy consisted of pyelonephritis in one patient, and stone street formations in three. In the group of ESWL+PCNL, one patient developed pyonephrosis, and another perinephritic abscess. No serious complication was noted in patients who underwent open surgery, but an average of 525 ml of blood transfusion was required.
We conclude that open stone surgery, although invasive, is still beneficial in the treatment of staghorn calculi.
KeywordsInternational Urology Extracorporeal Shock Wave Litholxip Stone Burden Staghorn Stone Staghorn Calculus
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- 1.Bossche, M. V., Simon, J., Schulman, C. C.: Shocks wave monotherapy of staghorn calculi.Eur. Urol., 17, 1 (1990).Google Scholar
- 3.Assimos, D. G., Wrenn, J. J., Harrison, L. H., McCullough, D. L., Boyce, W. H., Taylor, C. L., Zagoria, R. J., Dyer, R. B.: A comparison of anatrophic nephrolithotomy with and without extracorporeal shock wave lithotripsy for management of patients with staghorn calculi.J. Urol., 145, 710 (1991).PubMedGoogle Scholar
- 9.Lingemann, J. E., Smith, L., Woods, J. R., Newman, D. M.: Urinary Calculi: ESWL, Endourology and Medical Therapy. Lea & Febiger, Philadelphia 1989, pp. 163–191.Google Scholar
- 11.Rao, P. N., Holden, D.: Management of staghorn stones using a combination of lithotripsy, percutaneous nephrolithotomy and solution R irrigation.Br. J. Urol., 167, 13 (1991).Google Scholar
- 13.Sohn, M.: Anesthesia-free ESWL monotherapy with double J stents versus PCNL/ESWL combined approach in staghorn disease. A retrospective randomized study. In: Lingemann, J. E., Newman, D. M. (eds). Shock Wave Lithotripsy: State of the Art. Plenum Press, New York 1988, Chapter 18, pp. 95–100.Google Scholar
- 14.Fuchs, G. J., Fuchs, A. M., Royce, P. L., Stenzl, A., Chaussy, C. G.: Staghorn stone treatment with extracorporeal shock wave lithotripsy: The fate of residual stones. In: Lingemann, J. E., Newman, D. M. (eds): Shock Wave Lithotripsy State of the Art. Plenum Press, New York 1988, Chapter 19, pp. 101–104.Google Scholar