Anatrophic nephrolithotomy for managing large staghorn calculi

Abstract

Urinary stone diseases are most common problem, that urologists, encounter in their practice. Most of the stones are associated with some complications and recurrence. Staghorn stones are frequently responsible for morbidity, even death and chances of recurrence are more. Management of large staghorn stone is a challenging issue for complete clearance. Although there are several options for their management, only anatrophic nephrolithotomy has high stone free rate in single operative procedure. Aims and objectives: To find out the outcome of anatrophic nephrolithotomy for large staghorn renal stone. Methodology: Total 27 patients underwent anatrophic nephrolithotomy in this retrospective study at National Institute of Kidney Diseases & Urology from January 2004-June 2008. Patients selected for this study were with staghorn stone in any kidney larger than 5 cm. in size sonographically. Operation was done with clamping of renal artery and using surface cooling. Patients were followed up after operation upto a period of 5-42 months. Results: 27 patients (22 male and 5 female) were included in this study. Patients were between 36-68 years with mean 52 years. In 19 patients stones were on left side and in 8 patients on right side.23 patients (85.18%) had complete clearance of stone after operation, 4 patients (14.82%) had residual stones, they were managed subsequently with ESWL. 2 patients developed urine leakage and it improved conservatively. Conclusion: Anatrophic Nephrolithotomy appears to be a standard technique for management of large staghorn stone with very high stone free rate in a single operative procedure. Show more