Extensive nephrolithotomy in previously operated solitary kidneys

The surgical management of 2 patients with large dendritic calculi in previously operated solitary kidneys is presented. Complete nephrolithotomy was accomplished in situ using the anatropic nephrotomy technique of Smith and Boyce. Postoperatively a circle tube nephrostomy was used. The surgical management as described is recommended as an alternative to extracorporeal nephrolithotomy with autotransplantation or simple nephrectomy and dialysis.