A Clinical Observation on the Staghorn Calculi of the Kidney

Chung, O Y

Abstract

The author has made a clinical observation on 13 cases of staghorn calculi of the kidney with emphasis on operative results which were treated at the Department of Urology, Pusan National University Hospital during the 10 years from 1951 to 1970. The results were as follows: 1. Staghorn calculi of the kidney were found in 1.4% of the total admitted cases of urology. This estimate is consistent with 8.2% of the total urinary calculi. 69.2% of the cases were found in the age group of 41 to 60 years. 2. Urinalysis for the patients with renal staghorn calculi revealed markedly abnormal findings, whereas I.V.P. and renal scanning for them showed findings of relatively well preserved parenchymal tissues. These findings suggest that renal destruction due to obstruction is relatively mild because of the unique size and shape of the staghorn calculi. 3. As for treatment pyelonephrolithotomy in 4 cases nephrolithotomy in 4 cases, nephrectomy in 3 cases and medical treatment in 2 cases respectively were done, and 2 hours were taken for nephrectomy in average and 2 hours and 40 minutes for nephrolithotomy, 3 hours for pyelonephrolithotomy and in 20% of cases of conservative surgery remained fragments of stone were found. 4. Blood loss during operation amounted in average to 250cc. for nephrectomy. 425cc. for nephrolithotomy and 8500c. for pyelonephrolithotomy. 5. It seemed that a safe and useful method for surgical treatment of staghorn calculi could be obtained when the incision to the renal parenchyme was given on the most atrophied area with less than 2 cm in incisional length.