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The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones.

The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones. From March 1995 to May 1997, 104 patients underwent 115 supracostal percutaneous nephrolithotomy (PCNL) procedures for the treatment of 102 complete staghorn calculi, 6 large semistaghorn calculi, 3 large upper-caliceal stones, and 4 significant volumes of residual stone fragments after SWL. Additional renal access was required mainly for complete staghorn stones (23 patients; 20%). Extracor poreal lithotripsy was performed in 30.4% of cases, and second-look PCNL was done in 15.6%. The stone-free rate was 87%, and the infection-free rate at 7 to 33 months was 88.5%. Among 115 supracostal PCNL procedures, complications were encountered in 10 (8.7%). These problems included four large pleural effusions that were drained by chest tube in three patients and by repeated thoracocentesis in one patient. Six patients developed significant atelectasis, which was treated by vigorous physiotherapy in five and flexible bronchoscopy in one. We conclude that the supracostal approach provides direct and optimal access to most staghorn calculi with an excellent stone-free rate. The advantages of this approach can be achieved with a slight and acceptable increase in morbidity. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of endourology Pubmed

The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones.

Journal of endourology , Volume 12 (5): -397 – Feb 17, 1999

The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones.


Abstract

From March 1995 to May 1997, 104 patients underwent 115 supracostal percutaneous nephrolithotomy (PCNL) procedures for the treatment of 102 complete staghorn calculi, 6 large semistaghorn calculi, 3 large upper-caliceal stones, and 4 significant volumes of residual stone fragments after SWL. Additional renal access was required mainly for complete staghorn stones (23 patients; 20%). Extracor poreal lithotripsy was performed in 30.4% of cases, and second-look PCNL was done in 15.6%. The stone-free rate was 87%, and the infection-free rate at 7 to 33 months was 88.5%. Among 115 supracostal PCNL procedures, complications were encountered in 10 (8.7%). These problems included four large pleural effusions that were drained by chest tube in three patients and by repeated thoracocentesis in one patient. Six patients developed significant atelectasis, which was treated by vigorous physiotherapy in five and flexible bronchoscopy in one. We conclude that the supracostal approach provides direct and optimal access to most staghorn calculi with an excellent stone-free rate. The advantages of this approach can be achieved with a slight and acceptable increase in morbidity.

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ISSN
0892-7790
DOI
10.1089/end.1998.12.403
pmid
9847059

Abstract

From March 1995 to May 1997, 104 patients underwent 115 supracostal percutaneous nephrolithotomy (PCNL) procedures for the treatment of 102 complete staghorn calculi, 6 large semistaghorn calculi, 3 large upper-caliceal stones, and 4 significant volumes of residual stone fragments after SWL. Additional renal access was required mainly for complete staghorn stones (23 patients; 20%). Extracor poreal lithotripsy was performed in 30.4% of cases, and second-look PCNL was done in 15.6%. The stone-free rate was 87%, and the infection-free rate at 7 to 33 months was 88.5%. Among 115 supracostal PCNL procedures, complications were encountered in 10 (8.7%). These problems included four large pleural effusions that were drained by chest tube in three patients and by repeated thoracocentesis in one patient. Six patients developed significant atelectasis, which was treated by vigorous physiotherapy in five and flexible bronchoscopy in one. We conclude that the supracostal approach provides direct and optimal access to most staghorn calculi with an excellent stone-free rate. The advantages of this approach can be achieved with a slight and acceptable increase in morbidity.

Journal

Journal of endourologyPubmed

Published: Feb 17, 1999

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