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Percutaneous nephrolithotomy for calculi in horseshoe kidneys
D J Jones1, J E Wickham, M J Kellett
1Institute of Urology, London, England.
The Journal of Urology
|March 1, 1991
Summary
Percutaneous nephrolithotomy is an effective treatment for kidney stones in horseshoe kidneys. This minimally invasive procedure achieved an 88.8% stone clearance rate in a study of 15 patients.
Area of Science:
- Urology
- Nephrology
Background:
- Horseshoe kidneys present unique challenges for treating kidney stones (calculi).
- Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical technique.
Purpose of the Study:
- To evaluate the efficacy and safety of PCNL for calculi in horseshoe kidneys.
- To determine the stone clearance rate and identify potential complications.
Main Methods:
- A retrospective review of 15 patients (18 kidneys) who underwent PCNL between 1983 and 1988.
- Standard 1-stage PCNL with modifications, utilizing ultrasound or electrohydraulic lithotripsy for in situ disintegration.
- Assessment of stone-free status and complications, including the need for secondary treatments like extracorporeal shock wave lithotripsy (ESWL).
Main Results:
- PCNL was technically successful with minimal perioperative issues.
- In situ disintegration was required in 83.3% of moieties, and nephrostomy drainage in 66.7%.
- An overall stone clearance rate of 88.8% was achieved, with 77.8% stone-free after PCNL alone and an additional 11.1% after ESWL.
Conclusions:
- Percutaneous nephrolithotomy is a safe and acceptable treatment option for kidney stones in horseshoe kidneys.
- PCNL is the preferred treatment for patients with difficult or impossible imaging.
- The procedure demonstrates a high stone clearance rate with manageable complications.