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Percutaneous stone removal in horseshoe kidneys.
1Department of Surgery, Health Sciences Centre and University of Manitoba, Winnipeg, Canada.
The Journal of Urology
|August 24, 1999
Summary
Percutaneous nephrolithotomy effectively removes kidney stones in horseshoe kidneys when other methods fail. This procedure, often requiring multiple tracts and flexible nephroscopy, offers a safe and successful treatment option.
Area of Science:
- Urology
- Nephrology
- Surgical Innovation
Background:
- Horseshoe kidneys present unique challenges for kidney stone management.
- Extracorporeal shock wave lithotripsy may be unsuitable for large stone burdens in these anatomies.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for treating kidney stones in patients with horseshoe kidneys.
- To assess PCNL outcomes when extracorporeal shock wave lithotripsy is not a viable option.
Main Methods:
- A retrospective review of 12 consecutive patients with horseshoe kidneys and calculi treated with PCNL between 1988 and 1997.
- Analysis of stone burden, surgical techniques including nephrostomy tract creation, and clinical outcomes.
Main Results:
- Complete stone removal was achieved in 75% of patients (9 out of 12) using PCNL alone.
- Multiple nephrostomy tracts were necessary in 5 patients, with 4 requiring additional intraoperative nephrostomies.
- Flexible nephroscopy was crucial for complete stone removal in 82% of cases, and 3 patients needed second-look procedures.
Conclusions:
- Percutaneous nephrolithotomy is a safe and effective treatment for kidney stones in horseshoe kidneys.
- Optimal stone clearance may necessitate multiple nephrostomy tracts, flexible nephroscopy, and potential second-look procedures.