Comparative study of percutaneous access for staghorn calculi

Comparative study of percutaneous access for staghorn calculi

Autor Netto, N. R. Google Scholar
Ikonomidis, J. Google Scholar
Ikari, O. Google Scholar
Claro, J. A. Google Scholar
Instituição Universidade Estadual de Campinas (UNICAMP)
Hosp Israelita Albert Einstein
Universidade Federal de São Paulo (UNIFESP)
Resumo Objectives. To compare the success and complication rates of staghorn calculi treated through the upper pole calix, lower/middle calices, and multiple access.Methods. Between January 1995 and December 2000, the records of 119 patients with staghorn calculi who underwent percutaneous nephrolithotomy were retrospectively reviewed. the mean stone burden was 6.9 cm. of the 119 patients, 16 (13.4%) had upper pole access, 70 (58.8%) lower or middle calix access, and 33 (27.7%) multiple renal access.Results. the stone-free rate was 80.0% for those in the lower/middle, 87.5% for those in the upper pole, and 84.8% for those in the multiple access group. Single access was performed in 72.3% and multiple access tracts in 27.7% of patients. the average operative time was 86.8 minutes in the upper pole, 139.1 minutes in the lower/middle pole, and 134.9 minutes in the multiple access groups. Extracorporeal shock wave lithotripsy was used in 4.2% of patients. the overall complication rate was 28.5% (25% in the upper pole, 21.4% in the lower/middle, and 45.4% in the multiple access group). Thoracic complications (pneumothorax and hydrothorax) occurred in 2 patients (1.7%), but only 1 patient had undergone supracostal access. Bleeding requiring blood transfusion was significantly greater in the multiple access group. the average hospital stay was 3.0 days for all patients.Conclusions. the success of percutaneous treatment of patients with staghorn calculi is highly related to optimal kidney access. the supracostal and multiple access approaches can be used, with a slight increase in the incidence of acceptable complications. (c) 2005 Elsevier Inc.
Idioma Inglês
Data 2005-04-01
Publicado em Urology. New York: Elsevier B.V., v. 65, n. 4, p. 659-662, 2005.
ISSN 0090-4295 (Sherpa/Romeo, fator de impacto)
Editor Elsevier B.V.
Extensão 659-662
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000228557900006

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