Supine percutaneous nephrolithotomy in horseshoe kidney
Silvia Proietti1, Salvatore Di Pietro1, Mon Mon Oo1
1Department of Urology, European Training Centre of Endourology (ETCE), IRCCS San Raffaele Hospital, Milan, Italy.
Central European Journal of Urology
|September 30, 2024
Summary
Supine percutaneous nephrolithotomy (PCNL) is a safe and effective treatment for kidney stones in horseshoe kidney (HSK) patients. This study found a 72.9% stone-free rate with minimal complications in HSK patients undergoing supine PCNL.
Area of Science:
- Urology
- Nephrology
- Surgical Innovation
Background:
- Traditionally, percutaneous nephrolithotomy (PCNL) for horseshoe kidney (HSK) patients was performed in the prone position.
- The adoption of supine PCNL for general urinary stone cases has prompted investigation into its application for HSK patients.
Purpose of the Study:
- To evaluate the safety and effectiveness of the supine percutaneous nephrolithotomy (PCNL) technique in patients with horseshoe kidney (HSK) and urolithiasis.
Main Methods:
- A prospective study collected data from 35 HSK patients undergoing 48 supine PCNL procedures between June 2016 and June 2023.
- Stone volume was assessed via CT scans. Stone-free status was determined by postoperative non-contrast CT.
- Complications were classified using the Clavien-Dindo system, with stone-free rate (SFR) as the primary endpoint.
Main Results:
- The study included 35 patients (48 procedures), achieving a 72.9% stone-free rate at 1-month follow-up.
- Complications of Clavien-Dindo Grade I-II occurred in 22.9% of procedures (11/48).
- One case (2.1%) resulted in a Clavien-Dindo Grade IIIa complication.
Conclusions:
- Supine PCNL is a safe and effective treatment option for urolithiasis in horseshoe kidney (HSK) patients.
- The procedure demonstrated minimal morbidity in this prospective cohort.
- Further research may solidify supine PCNL as a standard approach for HSK stone management.
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