Surgical Management of Staghorn Calculi

Kang, Chang Soo; Chang, Sae Kook

Abstract

A clinical evaluation was made with particular attention to surgical management on patients with staghorn calculi who had been admitted to the Department of Urology, Kyungpook National University Hospital during 10 years periods from January, 1975 to December, 1984. The results were as follows: 1. Out of total 2,634 in-patients, 469 were due to urinary stones and 51 due to staghorn calculi. 51 patients with staghorn calculi were 2% of total admission and 11% of patients with urinary stones. 2. The calculus was unilateral in 50 patients (right in 25 and left in 25) and bilateral in 1. Of 5O unilateral staghorn calculi l was in left solitary kidney. 3. 49 patients had presenting symptomatology and 2 patients had no symptoms. The most common symptom was flank Rain(80.4 %). 4. Excretory urogram showed marked hydronephrosis in 8 cases, mild to moderate hydronephrosis in 3O normal collecting system in 3 and non-visualized kidney in 10. 5. Urine cultures yielded organism in 19 of 41 cases: E. coli, Klebsiella and Staphylococci in 4 respectively and Enterobacter in 3. 6. The treatment modality was surgical intervention .in 47 patients (48 operations) and conservative management in 4. 4S surgical interventions were nephrectomy in 10 and conservative treatment 38. Conservative surgery was extended pyelolithotomy in 12, extended pyelolithotomy with parenchymal extension in 11, anatrophic nephrolithotomy in 9, partial nephrectomy in 5, and extended pyelolithotomy with ureterocalicostomy in 1. 7. Except 6 cases with remnant calculi, no mortality and significant morbidity was found in 38 cases with staghorn calculi treated by conservative surgery.