Journals / Türk Üroloji Dergisi/Turkish Journal of Urology / 2007 / Cilt: 33 - Sayı: 3

Treatment of staghorn calculi: Experience of 199 patients treated by percutaneous nephrolithotomy

Geyik boynuzu (staghorn) taşlarının tedavisi: 199 hastalık perkütan nefrolitotomi deneyimi

Pages
317–323
DOI
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⚡ TL;DR(Too Long; Didn't Read)

Transfusion rates were significantly higher in the first 100 patients (Group 1 and 2) than the other 99 patients (Group 2 and 4) (49% in the first 100 patients, 10% in the other 99 patients, p=0.000) with an overall 59 transfusions in all patients.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: In this retrospective study, the success and complication rates of percutaneous nephrolithotomy (PCNL) operation in the treatment of staghorn stones were evaluated.
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Key Findings & Data:Materials and Methods: Between December 1997-September 2006, 199 patients (134 male and 65 female; mean age: 45.4) with staghorn calculi treated by PCNL at our institution were included in the study.
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Conclusion & Impact:Transfusion rates were significantly higher in the first 100 patients (Group 1 and 2) than the other 99 patients (Group 2 and 4) (49% in the first 100 patients, 10% in the other 99 patients, p=0.000) with an overall 59 transfusions in all patients.
🔬Design:Research Article
📍Scope:2006 Verileri
⚙️Variables:Yatış süresi · Ameliyat sonrası komplikasyonlar · Nefrostomi

Abstract

Introduction: In this retrospective study, the success and complication rates of percutaneous nephrolithotomy (PCNL) operation in the treatment of staghorn stones were evaluated. Materials and Methods: Between December 1997-September 2006, 199 patients (134 male and 65 female; mean age: 45.4) with staghorn calculi treated by PCNL at our institution were included in the study. In order to assess the influence of experience on success and morbidity, the patients were divided chronologically into four groups (50 patients in each first 3 groups and 49 patients in the last group). Results: The mean stone burden was 1869.2 mm2. When success was defined both as being stone-free or with clinically insignificant residual fragments (CIRF), PNL of 165 patients achieved success (82.9%), 44 of which (26.6%) had CIRF. Transfusion rates were significantly higher in the first 100 patients (Group 1 and 2) than the other 99 patients (Group 2 and 4) (49% in the first 100 patients, 10% in the other 99 patients, p=0.000) with an overall 59 transfusions in all patients. Lithotripter type, stone burden, operation time, number and site of access and rate of transfusion did not correlate with the success rate. Conclusion: As a consequence, PCNL is an effective treatment option of staghorn calculi with a slightly increase of complications.

Özet

Bu retrospektif çalışmada geyik boynuzu (staghorn) taşlarının tedavisinde bir seçenek olan perkütan nefrolitotomi (PNL) ameliyatının başarı ve istenmeyen yan etki oranları irdelenmiştir. Aralık 1997 - Eylül 2006 tarihleri arasında PNL ameliyatı yapılan 199 (134 erkek, 65 kadın) hasta çalışmaya alındı. Deneyimin başarı ve morbidite üzerine etkisini değerlendirmek için 199 hasta ameliyat zamanlarına göre 4 gruba ayrıldı: İlk üç grupta 50 hasta yer alırken son grupta 49 hasta vardı. Hastaların yaş ortalaması 45,4 (18-73) idi. Ortalama taş yükü 1869,2 mm2 bulundu. Başarı taşsızlık ve klinik önemi olmayan rezidü (KÖR) olarak tanımlandığında 165 (%82,9) hastanın ameliyatı başarıya ulaşırken bunların 44'ünde (%26,6) klinik önemi olmayan rezidü (KÖR) vardı. Kan transfllzyon oram ilk 100 hastada (%49) sonraki 99 hastaya (%10) göre anlamlı olarak daha yüksekti (p=0,000) Litotriptör cinsi, taş boyutu, ameliyat süresi, giriş yeri ve sayısı ve transfüzyon oranı ile başarı oranı ile arasında anlamlı ilişki saptanamadı. Sonuç olarak geyik boynuzu taşlarda PNL tedavisi istenmeyen yan etkilerde artışa neden olabilmesine karşın etkin bir yöntemdir.

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Cite This Article

EREN, M. T., İNCİ, K., TOMBUL, T., ÖZDEN, E., TAŞAR, Ç., ŞAHİN, A. (2007). Treatment of staghorn calculi: Experience of 199 patients treated by percutaneous nephrolithotomy. Türk Üroloji Dergisi/Turkish Journal of Urology, Cilt: 33 - Sayı: 3, 317–323. https://ajindex.com/articles/328750

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References (17)

  1. Lam HS, Lingeman JE, Russo R, Chua GT: Stone surface area determination techniques: A unifying concept of staghorn stone burden assessment. J Urol; 148: 1026- 9, 1992
  2. Gettman MT, Segura JW: Struvite stones: Diagnosis and current treatment concehst. J Endourol; 13: 653-8, 1999
  3. Ansari MS, Gupta NP, Hemal AK, et al: Spectrum of stone composition: Structural analysis of 1050 upper urinary tract calculi from northern India. Int J Urol; 12: 12- 6,2005
  4. Rous SN and Turner WR: Retrospective study of 95 patients with staghorn calculus disease. J Urol, 118: 902, 1977
  5. Koga S, Arakaki Y, Matsuoka M and Ohyama C: Staghorn calculi-long-term results of management. Br J Urol, 68: 122,1991
  6. Blandy JP, Singh M: The case for a more aggressive approach to staghorn stones. J Urol; 115: 505-6, 1976
  7. Sampaio FJ: Renal anatomy. Endourologic considerations. Urol Clin North Am.; 27: 585-607, 2000
  8. Streem SB, Geisinger MA, Risius B, Zelch MG and Siegel SW: Endourologic Sandwich Therapy for Extensive Staghorn Calculi. J Urol, 158: 342, 1997
  9. Bech EM and Riehle RA: The fate of residual fragments after extracorporeal Shockwave lithotripsy monotherapy of infection stones. J Urol, 145: 6, 1991
  10. Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS: AUA guideline on management of staghorn calculi: Diagnosis and treatment recommendations. J Urol; 173: 1991-2000, 2005
  11. Kohlany A, Shokeir AA, Mosbah A, et al: Treatment of complete Staghorn Stones: A prospective randomized comparison of open surgery versus percutaneous nephrolithotomy. J Urology; 173: 469,2005
  12. Netto NR, Ikonomidis J, et al: Comparative Study of Percutaneous Access For Staghorn Calculi. Urology; 65: 659-663,2005
  13. Aron M, Yadav R, Goel R, Kolla SB, Gautam G, Hemal AK, Gupta NP: Multi-tract percutaneous nephrolithotomy for large complete staghorn calculi. Urol Int.; 75: 327-32, 2005
  14. Munver R, Delvecchio FC, Newman GE, et al: Critical analysis of supracostal access for percutaneous renal surgery. J Urol 166: 1242-1246, 2001
  15. Kamat N: Upper pole access for complex lower polerenal calculi. BJU Int.; 94: 849-52; discussion 852, 2004
  16. Yadav R, Aron M, Gupta NP, Hemal AK, Seth A, Kolla SB: Safety of supracostal punctures for percutane-ous renal surgery. Int J Urol.; 13: 1267-70,2006
  17. Gupta R, Kumar A, Kapoor R, et al: Prospective evaluation of safety and efficacy of the supracostal approach for percutaneous nephrolithotomy. BJU Int; 90: 809-813,2002