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Minimally invasive percutaneous nephrolithotomy for upper urinary tract calculi in transplanted kidneys
Author(s) -
He Zhaohui,
Li Xun,
Chen Lizhong,
Zeng Guohua,
Yuan Jian
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.06768.x
Subject(s) - medicine , percutaneous nephrolithotomy , upper urinary tract , surgery , urinary system , urology , creatinine , percutaneous , nephrostomy , renal function
Authors from China describe their experience with percutaneous nephrolithotomy for upper urinary tract calculi in transplanted kidneys. They confirm that it is a suitable way to treat such stones, and suggest it as initial therapy for stones other than those in the middle or lower calyx, particularly if they are small stones. OBJECTIVE To report our experience with minimally invasive percutaneous nephrolithotomy (mPCNL) for upper urinary tract (UUT) calculi in transplanted kidneys. PATIENTS AND METHODS Between August 2002 and June 2006, seven patients (mean age 40.7 years) with UUT stones in transplanted kidneys (including one staghorn, two pelvic and four ureteric stones) were treated by mPCNL. A 16 F peel‐away sheath was placed as the percutaneous access port and a 8.5/11.5 F nephroscope or a 8/9.8 F ureteroscope was used for manipulation. Every 2–3 months during the follow‐up, patients had their serum urea, creatinine and uric acid measured, with urine culture and ultrasonography. RESULTS All patients were rendered stone‐free at one mPCNL procedure, with no complications during or after surgery. The mean (range) operative duration was 53 (20–100) min and the mean haemoglobin decrease was 0.55 (0.2–1.2) g/dL. At a mean (range) follow‐up of 23 (3–48) months renal allograft function was stable in all patients and no recurrence of stone was detected. CONCLUSIONS mPCNL is safe and effective for managing calculi in transplanted kidneys, and it can be the initial therapy for most cases of UUT stones in transplanted kidneys, except for simple and small stones in the middle or lower calyx.