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Staghorn calculi: percutaneous versus anatrophic nephrolithotomy
N Rodrigues Netto1, G C Lemos, P C Palma
1Division of Urology, University of Campinas Medical Center-UNICAMP, São Paulo, Brazil.
European Urology
|January 1, 1988
Summary
Percutaneous ultrasonic lithotripsy offers lower morbidity for staghorn stones compared to open surgery. This minimally invasive approach resulted in shorter procedures, faster recovery, and fewer complications, making it a preferable treatment option.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrolithiasis Management
Background:
- Staghorn stones pose complex treatment challenges.
- Traditional open surgery (anatrophic lithotomy) carries significant morbidity.
- Percutaneous nephrolithotomy (PCNL) is an alternative minimally invasive approach.
Purpose of the Study:
- To compare the morbidity of percutaneous ultrasonic lithotripsy (PUL) and anatrophic nephrolithotomy for staghorn stones.
- To evaluate key outcomes including success rate, complications, and recovery time.
Main Methods:
- Retrospective analysis of 75 patients with staghorn stones.
- Comparison between 46 patients treated with PUL and 29 patients treated with anatrophic lithotomy.
- Exclusion of 5 patients from the learning period.
Main Results:
- Complete stone removal: 73.8% for PUL vs. 82.1% for anatrophic lithotomy.
- Shorter procedure time (120 vs. 210 min), hospitalization (5 vs. 7 days), and analgesic need (1.6 vs. 4.7 doses) for PUL.
- Significantly lower overall complication rate (20.0% for PUL vs. 50.0% requiring interventions for open surgery).
- Faster return to normal activities for PUL patients (9 vs. 43 days).
Conclusions:
- Percutaneous ultrasonic lithotripsy demonstrates significantly lower morbidity compared to anatrophic lithotomy for staghorn stones.
- PUL offers advantages in terms of procedural efficiency, patient recovery, and complication rates.
- PCNL is a safer and more effective treatment for complex staghorn calculi.