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Long‐term results of percutaneous nephrolithotomy for treatment of staghorn stones
Author(s) -
ELNahas Ahmed R.,
Eraky Ibrahim,
Shokeir Ahmed A,
Shoma Ahmed M.,
ELAssmy Ahmed M.,
ELTabey Nasr A.,
ELKappany Hamdy A.,
ELKenawy Mahmoud R.
Publication year - 2011
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.2010.09942.x
Subject(s) - medicine , percutaneous nephrolithotomy , surgery , staghorn calculus , perioperative , renal function , percutaneous , nephrectomy , kidney
Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Short‐term results; as stone‐free and complication rates; of percutaneous nephrolithotomy for treatment of staghorn stones. Long‐term results of PNL; as recurrence rate and differential renal functional changes for treatment of staghorn stones with focus. OBJECTIVE • To study long‐term results of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones. PATIENTS AND METHODS • The records of patients who underwent PNL for staghorn stones between January 1998 and January 2008 were retrospectively reviewed. • Patients who completed follow‐up for one year or more were included. Follow‐up with KUB and renal ultrasonography were performed every 3–6 months. • Renal radioisotopic scan was performed for patients who had already undergone this study before doing PNL. RESULTS • The study included 122 patients (69 male and 53 female) with mean age 47.6 ± 14.5 years (5–74). They underwent 126 PNL. • Perioperative complications were encountered in 28 procedures (22%). The mean period of follow‐up was 3.5 ± 2.3 years (1–11.3). Among 71 stone‐free kidneys, 18 (25%) developed stone recurrence. Of 55 kidneys with residuals at the start of follow‐up, 36 (65%) showed growth of these residuals. • Preoperative and postoperative renograms were performed for 71 patients. • At the last follow‐up, differential GFR was stable in 53 (74.5%), improved in 12 (17%) and deteriorated in 6 (8.5%). Among patients with deteriorated renal function, 3 had undergone embolization to control severe bleeding, one developed secondary UPJO, and one had recurrent stone obstructing the kidney. CONCLUSION • Long‐term functional results of PNL for staghorn stones are satisfactory as 91.5% of kidneys showed stable or improved GFR. Long‐term follow‐up is mandatory especially for patients with residual stones.