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[Primary percutaneous approach in staghorn kidney calculus]
A Ponthieu1, P Basile, J Lorca
1Centre d'Urologie Castellane, Marseille.
Summary
Percutaneous nephrolithotomy is an effective treatment for staghorn calculi. While not always successful alone, it offers comparable results to surgery for complex kidney stones.
Area of Science:
- Nephrology
- Urology
- Surgical Technology
Background:
- Staghorn calculi are complex kidney stones.
- Percutaneous nephrolithotomy (PCNL) is a minimally invasive treatment option.
Purpose of the Study:
- To evaluate the efficacy of PCNL for treating staghorn calculi.
- To compare PCNL outcomes with surgical interventions.
Main Methods:
- Ultrasound-guided PCNL was performed on 36 patients with staghorn calculi (1983-1992).
- Stone size was measured by plain abdominal X-ray (mean area: 1,020 mm²).
- Branch length was measured from the pelvic element (mean: 50.2 mm).
Main Results:
- PCNL achieved complete stone removal in 12 of 36 patients.
- Of 24 residual stones, 16 were treated with extracorporeal shock-wave lithotripsy (ESWL), with complete success in 12.
- Overall failure rate was 11% (4 residual stones), comparable to surgical rates.
Conclusions:
- Primary PCNL is an effective therapeutic option for staghorn calculi.
- Treatment outcomes should be considered alongside surgical alternatives.
- Further evaluation is needed for complex stone management strategies.