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Current indications for open stone surgery in an endourology center
C J Kane1, D M Bolton, M L Stoller
1Department of Urology, University of California School of Medicine, San Francisco.
Objectives:
To evaluate the current indications and outcome of open stone surgery in a tertiary endourology unit.
Methods:
A 3-year retrospective review (1990 to 1993) of all endoscopic and open stone surgery was undertaken.
Results:
Twenty-five open procedures were performed on 20 patients of a total of 799 stone treatment procedures (3.13%). The most common indications for open stone surgery included large stone burdens in association with abnormal anatomy limiting endoscopic access (31%), concurrent open surgical procedures (24%), or previous failed endourologic procedures (17%). Anatomic factors contributing to the need for open surgery included renal transplantation, morbid obesity, and severe limb contractures.
Conclusions:
Open stone surgery has become more complex. Patients undergoing open surgery, who failed endourologic techniques, or for anatomic or medical reasons, currently are the cohorts who may still benefit from treatment for calculus disease using open surgical techniques.