Single lower calyceal percutaneous tract combined with flexible nephroscopy: A valuable treatment paradigm for staghorn stones

  • Stavros Sfoungaristos Hadassah University Medical Centre
  • Ioannis Mykoniatis 1st Urology Department, Aristotle University of Thessaloniki
  • Ioannis katafigiotis Laiko Hospital, 1st Urology Department, University of Athens
  • Ayman Isid Hadassah University Medical Centre
  • Ofer N. Gofrit Hadassah University Medical Centre
  • Constantinos A. Constantinides Laiko Hospital, 1st Urology Department, University of Athens
  • Mordechai Duvdevani Hadassah University Medical Centre

Abstract

Introduction: We evaluated the efficacy and safety of single lower calyceal tract combined with flexible nephroscopy for the management of staghorn renal stones by percutaneous nephrolithotomy.

Methods: The medical records of patients who underwent percutaneous nephrolithotomy for the management of staghorn stones were analyzed. We included patients aged >18 years, while patients with incomplete data and renal anatomical anomalies were excluded from the study. Stone-free rate, postoperative complications, procedure duration, fluoroscopy time, and length of hospitalization were recorded. Postoperative outcomes were evaluated by non-contrast computed tomography scan 4–6 weeks after the operation. Stonefree status was defined as the absence of residual stones >4 mm.

Results: The study cohort consisted of 103 consecutive patients. Stonefree rate was 65.0%. No complications were observed in 69.9% of the cases; most postoperative complications were Grade 1 (13.6%) and 2 (10.7%). Five patients (4.9%) suffered a Grade 3a complication and another patient (1.0%) suffered a Grade 3b complication.

Conclusions: Percutaneous nephrolithotomy through a single lower calyceal tract combined with flexible nephroscopy can be a valuable treatment option for the treatment of staghorn calculi, providing efficacy and safety. Nevertheless, the present study is limited by both its retrospective nature and being conducted at a single centre and, thus, proper prospective studies with head-on comparisons are needed to prove or disprove the advantages and disadvantages of either approach.

Published
2017-11-23
How to Cite
Sfoungaristos, S., Mykoniatis, I., katafigiotis, I., Isid, A., Gofrit, O. N., Constantinides, C. A., & Duvdevani, M. (2017). Single lower calyceal percutaneous tract combined with flexible nephroscopy: A valuable treatment paradigm for staghorn stones. Canadian Urological Association Journal, 12(1), E21-4. https://doi.org/10.5489/cuaj.4393
Section
Original Research