Open stone surgery: a still-in-use approach for complex stone burden

Area of Science:

• Urology
• Surgical Innovation
• Nephrolithiasis Management

Background:

• Urinary stone disease is a prevalent urological condition.
• Endourologic techniques have advanced treatment, but open surgery remains relevant for complex cases.
• Open stone surgery has historical significance and efficacy in managing challenging kidney stone burdens.

Purpose of the Study:

• To evaluate the outcomes of open stone surgery for complex urinary stone disease.
• To assess the safety and efficacy of open stone removal in a series of patients.
• To highlight the continued role of open surgery in contemporary urological practice.

Main Methods:

• Retrospective analysis of 18 patients who underwent open stone surgery for complex urinary stone disease.
• Evaluation of demographic data, stone analysis, and postoperative outcomes.
• Surgical approach selection was primarily surgeon-dependent, with some cases due to perioperative complications.

Main Results:

• No Clavien-Dindo grade 4 or 5 complications were observed.
• The stone-free rate was 83.3% (15 out of 18 patients).
• Mean operation time was 84 minutes, and mean hospitalization was 5.5 days, with manageable postoperative complications.

Conclusions:

• Open stone surgery maintains an indispensable role in managing complicated urinary stone disease and complex stone burdens.
• It serves as a valid alternative to endourologic techniques, particularly in challenging clinical scenarios.
• The study reaffirms the effectiveness and safety of open stone surgery for select patient populations.