Ochoa-del Real JM, González GF, Galeana-Ruiz R

Language: Spanish
References: 14
Page: 354-359
PDF size: 768.05 Kb.

ABSTRACT

Objective: To evaluate the effects of open renal surgery and failed extracorporeal shock wave lithotripsy treatment on the performance and final results of percutaneous nephrolithotomy.
Methods: A total of seventy-four consecutive percutaneous nephrolithotomy procedures were carried out as treatment for kidney stones at the authors’ institution from January 2007 to October 2009. Of that total, eight patients (10.8%) had a history of failed extracorporeal shock wave lithotripsy on the same side and made up Group 1. Fifteen patients of the total (20.3%) had a history of open kidney surgery, with or without extracorporeal shock wave lithotripsy, on the same kidney and made up Group 2. The remaining fiftyone patients (68.9%) with no history of open kidney surgery or extracorporeal shock wave lithotripsy made up Group 3. Patient demographics, stone characteristics, surgical findings, including surgery duration, collecting system access time, fluoroscopy duration, success percentage, need for auxiliary treatment, and complications were documented in detail and compared among all groups.
Results: There were no differences among the three groups in regard to age, sex, weight, and stone laterality. Mean surgery duration, collecting system access time, fluoroscopic scan duration, complication frequency, nephrostomy removal time, and hospital stay were similar for each group (P›0.05 for each parameter). Stone-free percentages after percutaneous nephrolithotomy were 75% in Group 1, 73.3% in Group 2, and 68.6% in Group 3. These percentages increased to 100%, 80%, and 92.2%, in Groups 1, 2, and 3, respectively, after a second intervention (percutaneous nephrolithotomy, extracorporeal shock wave lithotripsy, or nephroureteroscopy).
Conclusions: The present study clearly shows that percutaneous nephrolithotomy as standard technique can be safely carried out in patients with a past medical history of open nephrolithotomy or extracorporeal shock wave lithotripsy with no higher complication risk and with a success rate similar to those percutaneous nephrolithotomy patients with no previous intervention.

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