TY - JOUR
T1 - Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy
AU - Landman, Jaime
AU - Venkatesh, Ramakrishna
AU - Lee, David I.
AU - Rehman, Jamil
AU - Ragab, Maged
AU - Darcy, Michael
AU - Sundaram, Chandru P.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Purpose: We describe our technique and clinical experience with application of the ureteral access sheath for single access ablation of staghorn and partial staghorn calculi. Materials and Methods: We retrospectively reviewed our experience with 9 patients who underwent percutaneous nephrolithotomy for staghorn (6) or partial staghorn (3) renal calculi using a combined antegrade and retrograde approach. Patient data, operative parameters, efficacy of stone ablation and convalescence parameters were reviewed. Results: Mean operative time for the primary procedure was 3.1 hours with a mean estimated blood loss of 290 ml. Postoperatively, the mean analgesic requirement was 33.2 mg. MSO4 equivalents. Hospital stay was 3.2 days. There were no major and 4 minor (44%) complications. No patient required transfusion. Complete stone clearance was achieved in 7 of the 9 cases (78%) using a single percutaneous nephrostomy tract. Conclusions: Our preliminary clinical experience using the ureteral access sheath during percutaneous nephrolithotomy for simultaneous antegrade and retrograde stone treatment has been favorable. A large renal stone burden can be successfully managed with a single percutaneous access and limited blood loss.
AB - Purpose: We describe our technique and clinical experience with application of the ureteral access sheath for single access ablation of staghorn and partial staghorn calculi. Materials and Methods: We retrospectively reviewed our experience with 9 patients who underwent percutaneous nephrolithotomy for staghorn (6) or partial staghorn (3) renal calculi using a combined antegrade and retrograde approach. Patient data, operative parameters, efficacy of stone ablation and convalescence parameters were reviewed. Results: Mean operative time for the primary procedure was 3.1 hours with a mean estimated blood loss of 290 ml. Postoperatively, the mean analgesic requirement was 33.2 mg. MSO4 equivalents. Hospital stay was 3.2 days. There were no major and 4 minor (44%) complications. No patient required transfusion. Complete stone clearance was achieved in 7 of the 9 cases (78%) using a single percutaneous nephrostomy tract. Conclusions: Our preliminary clinical experience using the ureteral access sheath during percutaneous nephrolithotomy for simultaneous antegrade and retrograde stone treatment has been favorable. A large renal stone burden can be successfully managed with a single percutaneous access and limited blood loss.
KW - Kidney
KW - Kidney calculi
KW - Nephrostomy, percutaneous
KW - Surgical instruments
KW - Ureter
UR - http://www.scopus.com/inward/record.url?scp=0037213745&partnerID=8YFLogxK
U2 - 10.1016/S0022-5347(05)64036-0
DO - 10.1016/S0022-5347(05)64036-0
M3 - Article
C2 - 12478104
AN - SCOPUS:0037213745
VL - 169
SP - 64
EP - 67
JO - The Journal of Urology
JF - The Journal of Urology
SN - 0022-5347
IS - 1
ER -