Percutaneous nephrolithotomy in treatment of large stones within horseshoe kidneys

Urology
Ahmed A ShokeirHamdy A El-Kappany

Abstract

To present our experience with percutaneous nephrolithotomy (PCNL) in the treatment of large stones within horseshoe kidneys. The study included 34 patients with 45 stone-bearing horseshoe kidneys treated by PCNL in one center. The indications for PCNL were large stone burden (greater than 2 cm) in 10 kidneys (22.2%), multiple complex stones in 22 (48.9%), staghorn stones in 3 (6.7%), and failed extracorporeal shock wave lithotripsy (ESWL) in 10 kidneys (22.2%). All PCNL procedures were performed in a standard one-session technique with fluoroscopic guidance. Procedures were evaluated for intraoperative and postoperative complications, use of auxiliary procedures (second-look PCNL, ureteroscopy, and ESWL), and length of hospital stay. Moreover, the stone-free rate was calculated at discharge from the hospital and 3 months later. In addition, we assessed the need for secondary intervention during a mean follow-up of 75 +/- 16 months (range 6 to 108). The stone burden ranged from 264 to 2408 mm(2) (mean 664 +/- 153). Access to the horseshoe kidneys was supracostal in 10 (22.2%) and subcostal in 35 kidneys (77.8%). A single tract was used in 37 (82%), and two tracts were created in the remaining 8 kidneys (18%). Major complication...Continue Reading

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