Mini-percutaneous nephrolithotomy for stones in anomalous-kidneys: a prospective study

AbstractTo evaluate safety and efficacy of minipercutaneous nephrolithotomy (Mini-PNL) in management of stones in different types of renal anomalies. Patients with stones ≥2 cm or SWL-resistant stones in anomalous-kidneys treated by Mini-PNL between March 2010 and September 2012 were included prospectively. Mini-PNL was done under regional anesthesia in prone position with fluoroscopic guidance through 18 Fr sheath using semirigid ureteroscope (8.5/11.5 Fr) and pn eumatic lithotripter. All patients were followed-up for 2–3 years. Stone-free rate was defined as absence of residual fragments ≥2 mm. Student-T, Mann –Whitney, Chi square (χ2), Fisher-exact, one way ANOVA or Kruskal –Wallis test were used for analysis. Mini-PNL was performed for 59 patients (20 horseshoe, 15 malrotated, 7 polycystic, 13 duplex and 4 ectopic pelvic-kidneys). Mean age was 40.18 ± 12.75 (14–78) years. Mean stone burden was 31.72 ± 21.43 (7.85–141.3) mm2. Two tracts were required in 7 (11.9  %) patients. Tubeless Mini-PNL with double-J insertion was performed in all patients except two. Operative time was 50.17 ± 18.73 (15–105) min. Hemoglobin loss was 0.44 ± 0.30 (0–1.4) g/dL. Complications were reported in 15 (25.4 %) patients. No pleural injury, sepsis, perinephric-col lection or renal-pelvis perforation were reported. Stone-free rate was 89.8 % (converted to open-surgery in one patient, second-look PNL in two patients, auxiliary SWL in three patients). Stone...
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research