scholarly journals Percutaneous Nephrolithotomy and Horseshoe Kidneys

2020 ◽  
Vol 3 (2) ◽  
pp. 343-346
Author(s):  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parash Mani Shrestha ◽  
Biswa Raj Joshi
Keyword(s):  
Retrospective Study ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Ureteropelvic Junction Obstruction ◽  
Horseshoe Kidney ◽  
Standard Technique ◽  
Stone Clearance ◽  
Percutaneous Access ◽  
Staghorn Calculus ◽  
Collecting System

Introduction: The most common fusion anomaly, horseshoe kidney, is associated with vascular anomalies, malrotation, anterior displacement of the collecting system, superior insertion of ureter into the pelvis, and a higher rate of ureteropelvic junction obstruction; thus increasing the chances of nephrolithiasis. We present our experience with percutaneous nephrolithotomy in this anomaly.Materials and Methods: A retrospective study of all the percutaneous nephrolithotomy performed by standard technique within four years at Bir Hospital was made. A comparison was made with similar cases with the anatomically normal location of the kidney. Intraoperative variables were recorded and postoperative stonefree status and complications were evaluated.Results: Six hundred and twenty-seven patients out of 691 who had undergone percutaneous nephrolithotomy in this period were included. Patients with nephrolithiasis in horseshoe kidney were younger, the incidence of multiple stones was more; without full staghorn calculus and occupying fewer calyces. Upper pole access was easier, a stone clearance of 85.42 % was achieved with no major complications in the horseshoe kidney.Conclusions: Percutaneous access and nephrolithotomy are safe in horseshoe kidney with a good stone clearance rate.

scholarly journals Lumbar plexopathy as a complication of percutaneous nephrolithotomy in a horseshoe kidney

2015 ◽  
Vol 9 (1-2) ◽  
pp. 78 ◽  
Author(s):  
Andrea Gail Lantz ◽  
R. John D'A Honey
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Psoas Muscle ◽  
Horseshoe Kidney ◽  
Vascular Supply ◽  
Stone Disease ◽  
Laparoscopic Pyelolithotomy ◽  
Staghorn Calculus ◽  
Leg Weakness ◽  
Independent Ambulation ◽  
Collecting System

Treatment of nephrolithiasis in horseshoe kidneys can be challenging due to anomalies in renal position, collecting system anatomy and vascular supply. We report on a patient who was referred after a failed percutaneous nephrolithotomy for a left moiety staghorn calculus in a horseshoe kidney. Two punctures had been performed involving upper and middle posterior calyces. Both were very medially placed and inadvertently traversed the psoas muscle, resulting in lumbar plexopathy with permanent deficit. This complication presented postoperatively with left leg weakness, paresthesia, and pain which impaired independent ambulation. The patient went on to be successfully treated for her stone disease with robotic-assisted laparoscopic pyelolithotomy.

scholarly journals Percutaneous nephrolithotomy for large renal stones in anomalous kidneys

2020 ◽  
Vol 7 (12) ◽  
pp. 3971
Author(s):  
Syed Javid F. Qadri ◽  
Mufti Mahmood Ahmed ◽  
Zafar Saleem Khanday ◽  
Asim Leharwaal
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Preoperative Evaluation ◽  
Renal Stones ◽  
Technical Expertise ◽  
Single Centre ◽  
Stone Clearance ◽  
Single Centre Study ◽  
Staghorn Calculus ◽  
Operating Surgeon ◽  
Selection Of

Background: Percutaneous nephrolithotomy (PCNL) is an important surgical method for managing renal stones of any size. Anomalous kidneys pose additional technical challenge to the operating surgeon to perform PCNL in these anatomically abnormal kidneys especially if the stone load is large. The aim of this study is to present the efficacy and limitations of PCNL in managing stones >2 cm in size in anomalous kidneys.Methods: This was a retrospective single centre study of PCNL in anomalous kidneys with stones >2 cm in size.Results: 30 patients of kidney stones >2 cm underwent PCNL. Our series of patients included 19 (63.32%) cases of horseshoe kidneys, 9 (30%) malrotated kidneys, 1 (3.34%) pelvic and 1 (3.34%) crossed fused ectopia. We achieved complete stone clearance in 26 (86.67%) patients. Presence of staghorn calculus was the most important statistically significant factor limiting complete clearance.Conclusion: PCNL is an effective procedure for management of patients with large stones in anomalous kidneys. Appropriate preoperative evaluation especially imaging, appropriate selection of cases and most importantly excellent technical expertise is needed to achieve high stone clearance rates with minimal morbidity.

scholarly journals Effectiveness and Safety of Percutaneous Nephrolithotomy (PCNL) in Malrotated Kidneys

2021 ◽  
Vol 15 (8) ◽  
pp. 2362-2365
Author(s):  
Sami ur Rehman ◽  
Liaqat Ali ◽  
Jehanzeb . ◽  
Muhammad Asif ◽  
Syed Arif ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Technique ◽  
Percutaneous Nephrolithotomy ◽  
Preoperative Evaluation ◽  
Renal Stones ◽  
Stone Size ◽  
Stone Clearance ◽  
Large Size ◽  
Group I ◽  
Staghorn Stone

Background and Aim: The renal stones of any size could be effectively managed through an essential surgical technique known as Percutaneous Nephrolithotomy (PCNL). The large size renal stones with abnormal kidneys imposed additional challenges for PNCL in anomalous kidneys. The present study aimed to evaluate the effectiveness and safety of Percutaneous Nephrolithotomy in malrotated kidneys. Place and Duration: Conducted at Urology department of Mian Gul Abdulhaq Jehanzeb Kidney Hospital Manglawar, Swat for duration of two years (from May 2019 to April 2021). Materials and Methods. This single-centered retrospective study was conducted on 80 patients who underwent percutaneous nephrolithotomy with malrotation kidneys. The individuals with anomalous kidneys and complex calculi were enrolled in this study. These patients had kidneys anomalies such as horseshoe kidneys, crossed fused ectopia, malrotation kidneys, pelvic and complete stone clearance. Posterior or anterior approaches were followed for the procedure after preoperative evaluation in kidney anomalies. Retrograde catheterization was carried out under spinal and general anesthesia with the patients. For all the patients, stone size and clearance were measured. Results: Of the total 80 kidneys anomalies patients, 55 (68.7%) were male and 25 (31.3%) were females. Overall mean age was 35.26 ± 13.51. The stone size varied from 1.3cm to 7 cm. Patients were categorized into two groups based on stone sizes such as group I (1.3-2.5 cm) had 42 (52.5%) and group II (25-7cm) 38 (47.5%) patients. The patients included renal pelvis 19 (23.6%), the pelvic ureteric junction (PUJ) 8 (10%), horseshoe kidneys 2 (2.5%), crossed fused ectopia 9 (11.3%), and malrotation kidneys 3 (3.8%).The stone clearance was completed in 77 (96.3%) patients. The statistically significant factor for complete clearance was the staghorn stone calculus. Conclusion: Percutaneous nephrolithotomy is a safe and effective procedure for large renal stones management in patients of anomalous kidneys. Higher renal stones clearance can be achieved with minimum morbidity by suitable preoperative evaluation and technical experts. Keywords: Malrotated kidney; Nephrostomy, Percutaneous; Nephrolithiasis; Abnormality

scholarly journals Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

2018 ◽  
Vol 16 (3) ◽  
pp. 274-278
Author(s):  
Udaya Man Singh Dongol ◽  
Sandeep Bohora
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Operating Time ◽  
Lower Pole ◽  
Stone Size ◽  
Stone Clearance ◽  
Minimally Invasive Surgical ◽  
The Mean ◽  
Complications Rate

Background:  Urolithiasis is a worldwide problem  due to its high prevalence and  recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and  efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones.Methods: Seventy  patients who presented in between June 2013 and September 2017 with  lower pole calyceal stones and lower calyceal stones with pelvic extension  were included in the study. The  operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.

Asymptomatic emphysematous pyelitis—a rare clinical entity

2021 ◽  
Vol 14 (1) ◽  
pp. e235421
Author(s):  
Hannah Thorman ◽  
Nikita R Bhatt ◽  
Sona Kapoor ◽  
Azad Hawizy
Keyword(s):  
Renal Function ◽  
Percutaneous Nephrolithotomy ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Distal Ureter ◽  
Asymptomatic Woman ◽  
Significant Volume ◽  
Staghorn Calculus ◽  
The Right ◽  
Collecting System

A 62-year-old asymptomatic woman with diabetes was referred to the urology department from nephrology due to deterioration in renal function with accompanied right-sided hydronephrosis on ultrasound. CT imaging subsequently revealed a right-sided staghorn calculus and a significant volume of gas in the right collecting system from the kidney to the distal ureter, in keeping with emphysematous pyelitis. She was admitted and managed with antibiotics and insertion of right nephrostomy in the first instance, followed by percutaneous nephrolithotomy to definitively manage the stone. The patient remained asymptomatic throughout the process.

scholarly journals Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

2018 ◽  
Vol 16 (3) ◽  
pp. 274-278
Author(s):  
Udaya Man Singh Dongol ◽  
Sandeep Bohora
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Operating Time ◽  
Lower Pole ◽  
Stone Size ◽  
Stone Clearance ◽  
Minimally Invasive Surgical ◽  
The Mean ◽  
Complications Rate

Background: Urolithiasis is a worldwide problem  due to its high prevalence and  recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and  efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones. Methods: Seventy  patients who presented in between June 2013 and September 2017 with  lower pole calyceal stones and lower calyceal stones with pelvic extension  were included in the study. The operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.Keywords: Lower calyx; lower pole stones; percutaneous nephrolithotomy; stone free rate.

Does body mass index impact the efficacy and complication rate of mini-percutaneous nephrolithotomy?

2020 ◽  
pp. 205141582093688
Author(s):  
Hannah Burns ◽  
Nafees Ahmad ◽  
Jane Hendry ◽  
Sarath Nalagatla
Keyword(s):  
Body Mass Index ◽  
Length Of Stay ◽  
Body Mass ◽  
Percutaneous Nephrolithotomy ◽  
Complication Rate ◽  
Clearance Rate ◽  
Obese Patients ◽  
Clearance Rates ◽  
Stone Clearance ◽  
Severely Obese

Aim: This was a retrospective cohort study exploring the efficacy of mini-percutaneous nephrolithotomy in obese patients and whether stone clearance, complication rate and length of stay is impacted by an increasing body mass index. Method: Data was collected retrospectively for all mini-percutaneous nephrolithotomies performed at a single centre over a 21-month period commencing March 2017. The primary outcomes included length of stay, stone clearance rates and complications. Results: Fifty-eight percutaneous nephrolithotomies were undertaken during the study period and of these cases 81% of patients had a body mass index of 25 or greater. The stone clearance rate was 83%. However, severely obese patients were noted to have a lower stone clearance rate. No complications occurred in the normal body mass index cohort. However, there was no difference in the complication rate for the remaining groups. Post-operative stay was approximately 3 days. Conclusion: This study demonstrates that supine mini-percutaneous nephrolithotomies are a safe option in obese patients with no increased risk of serious complication. Whilst stone clearance rates were lower in the severely obese category, clearance was complete in the majority of cases. Level of evidence: 3

scholarly journals Anatrophic Nephrolithotomy for The Management of Large Complete Staghorn Calculi

2018 ◽  
Vol 6 (4) ◽  
pp. 140-144
Author(s):  
Udaya Man Singh Dongol ◽  
Sandeep Bohora
Keyword(s):  
Blood Transfusion ◽  
Clearance Rate ◽  
Operating Time ◽  
Cold Ischemia Time ◽  
Cold Ischemia ◽  
Stone Clearance ◽  
Ischemia Time ◽  
Staghorn Calculi ◽  
Staghorn Calculus ◽  
The Mean

Background: Complete staghorn calculus is a challenging issue in urological practice. Anatrophic nephrolithotomy is a major surgery frequently performed for a large complete staghorn calculus. Current endourological procedures like percutaneous nephrolithotomy or extracorporeal lithotripsy or retrograde intra renal surgery are less effective in the management of complete large staghorn calculi.Objectives: The objective of this study is to assess the safety and effi cacy of anatrophic nephrolithotomy in the management of complete large staghorn calculus diseases.Methodology: Total 25 adult patients with complete staghorn calculi from March 2012 to the fi rst week of Sept 2017 were included in the study and were evaluated for patient demography, operating time, blood transfusion rate, cold ischemia time, hospitalization duration, stone clearance rate and the complications.Results: Twenty five adult patients with the mean age of 36 years (26-73years) and the mean stone size of 50 mm (40- 65mm) underwent anatrophic nephrolithotomy. Fifteen were male patients and 10 female patients. The mean operating time was 156 minutes (130—210 minutes) and the cold ischemia time was 41 minutes (33-54 minutes). Six patients (24%) needed blood transfusion. The duration of hospital stay was 7.2 days (6–11 days). The stone clearance rate was 88 % at the time of discharge and 96 % at three month follow up.Conclusion: Anatrophic nephrolithotomy is a valid and useful approach and is a reasonable alternative in selected patients with complete large staghorn calculi. It can achieve high stone free rate with very low morbidity and low cost. Journal of Kathmandu Medical College,Vol. 6, No. 4, Issue 22, Oct.-Dec., 2017, Page: 140-144

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