[Primary percutaneous approach in staghorn kidney calculus]

Centre d'Urologie Castellane, Marseille.

36 staghorn calculi were treated percutaneously under ultrasound guidance between 1983 and 1992. Each stone had a renal pelvic element and at least two caliceal branches. The area of each stone was measured on the plain abdominal x-ray (mean: 1,020 mm2) and the total length of the various caliceal branches was measured from the pelvic element (mean: 50.2 mm). These 36 procedures represented 8.2% of the 438 percutaneous nephrolithotomies performed over the same period. The stone was able to be entirely removed by nephrolithotomy in 12 patients. Of the 24 residual stones after percutaneous nephrolithotomy, 16 were treated by extracorporeal shock-wave lithotripsy, which eliminated all stones in 12 of these patients. Eight of the remaining 12 patients were lost to follow-up and treatment was not completed, and 4 present a residual stone (11% of failures). These results are compared with those of other series and are comparable to those of surgery which gives a similar residual stone rate of 16% in the AFU 1982 report [6]. The primary percutaneous approach to staghorn calculi therefore represents an effective therapeutic modality, whose use and results must be weighed up with those of surgery.

PMID: 7719363 [PubMed - indexed for MEDLINE]