Surgical Management of Staghorn Calculi

Lee, You Sik; Lim, Su Kil

Abstract

The morbidity and mortality rates are believed to be much higher if the staghorn calculus is left unoperated, since complications resulting from infection and/or obstruction may become life-threating. So, surgical removal is essential element in the successful management of the majority of patients with staghorn calculous disease. To understand better the optimal management, we did a retrospective analysis of 41 patients treated during 12 year periods. Surgical managements were performed in 36 patients (41 kidneys) and no operation in 5. Methods of surgical managements were extended pyelolithotomy in 11 cases, extended pyelolithotomy and pyeloplasty in 1, extended pyelolithotomy with parenchymal extension in 4, ex- tended pyelolithotomy with parenchymal extension and partial nephrectomy in 1, anatrophic nephrolithotomy in 7, antrophic nephrolithotomy with partial nephrectomy in 3, partial nephrectomy in 3, partial nephrectomy in 3 and nephrectomy in 9. Complete removals of calculi were done in 32 kidneys(69.6%). Clinical complications occurred in 14 kidneys(30.4%) ; 5 were remnant stones(10.8%), massive bleeding in 2, renal artery injury in 1, urine leakage in 3, pneumothorax in 2 and hematuria and sepsis in 1. The managements of complications were reoperation in 8 cases, conservative treatment in 5 and no follow up in 1.