Surgical Management of Renal Calculi

Kwon, Soon Hwon; Cnang, Sae Kook

Abstract

A clinical evaluation was made with particular attention to surgical management on 156 patients with renal calculi who had been admitted to the Department of Urology, Kyungpook National University Hospital during 1O years periods from January, 1976 to December, l985. The results were as follows: 1. The calculus was unilateral in 144 patients (right in 73 and left in 71) and bilateral in l2.57 patients had staghorn calculi, 62 either single or multiple pelvic calculi, 20 either single or multiple calyceal calculi, and 17 multiple pelvic and calyceal calculi. 2. The treatment modality was surgical intervention in l39 patients(143 operations) and conservative management in 17.143 surgical interventions were nephrectomy in 17 and conservative surgery in 126. Conservative surgery was simple pyelolithotomy in 14, extended pyelolithotomy in 59, extended pyelolithotomy with parenchymal extension in 21, radial nephrolithotomy in 4, anatrophic nephrolithotomy in l4, partial nephrectomy in l3, and extended pyelolithotomy with ureterocalycostomy in 1. 41 operations with nephrotomy were done using in situ hypothermia. 3. 60 surgical interventions for pelvic calculi were simple pyelolithotomy in 14, extended pyelolithotomy in 40, extended pyelolithotomy with parenchymal extension in 2, and nephrectomy in 4.l9 surgical interventions for calyceal calculi were extended pyelolithotomy in 4, extended pyelolithotomy with parenchymal extension in 4, radial nephrolithotomy in 3, partial nephrectomy in 6, and nephrectomy in 2. 14 surgical interventions for pelvic and calyceal calculi were extended pyelolithotomy in 1, extended pyelolithotomy with parenchymal extension in 3, radial nephrolithotomy in l, anatrophic nephrolithotomy in 2, and partial nephrectomy in 5. 50 surgical interventions for stag horn calculi were extended pyelolithotomy in 14, extended pyelolithotomy with parenchymal extension in 2, anatrophic nephrolithotomy in 14, partial nephrectomy in 5, and nephrectomy in 6. 4. Except for 15 cases with remnant calculi and 1 with nephrectomy, no mortality nor significant morbidity was found 126 cases with renal calculi treated by conservative surgery. Cases found to have remnant calculi after surgical procedures were 1 out of 14 pyelolithotomies, 6 out of 59 extended pyelolithotomies, 4 out of 21 extended pyelolithotomy with parenchymal 2 extension, out of 14 anatrophic nephrolithotomies, and 1 out of 4 radial nephrolithotomies.