Laparoscopic pyelolithotomy for staghorn kidney stones. A multi-center study


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Abstract

Aim. To analyze the effectiveness and safety of laparoscopic pyelolithotomy (LP) in treating staghorn stones. Materials and methods. A multicentre retrospective analysis of the results of LP performed from January 2004 to December 2016 was conducted. Inclusion criteria: patients with staghorn calculi K3-K4, who underwent LP as an alternative to percutaneous nephrolithotripsy. The analysis included the incidence and structure of intra- and postoperative complications, the causes of access conversion, operating time, duration of postoperative hospital stay and stone clearance. Results. A total of 137 patients met the inclusion criteria, including 78 (56.93%) men. There was no mortality and access conversion. Intraoperative complications occurred in 2 (1.46%) patients. Operating time was 130 [100; 150] min, blood loss was 150 [100; 200] ml. No need for blood transfusion was observed. The cumulative rate of postoperative complications was 5.11%, stone clearance was achieved in 86.13% of observations, the duration of postoperative hospital stay was 7 [7; 11] days. Conclusion. In cases of dense staghorn calculi located in a large «extrarenal» pelvis and have calyceal branches equal to the diameter of their necks, laparoscopic pyelolithotomy is an alternative not only to open, but also to percutaneous surgery.

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About the authors

A. D Kochkin

Clinical Hospital at Nizhny Novgorod Railway Station of JSC «RZD»

Email: kochman@bk.ru
Ph.D., Urologist at the Department of Urology

E. A Gallyamov

A.I. Evdokimov MSUMD

Email: gal_svetlana@mail.ru
Dr.Med.Sci., Prof. at the Department of Faculty Surgery №1

V. L Medvedev

KubSMU of Minzdrav of Russia

Email: kkb1@mail.ru
Dr.Med.Sci., Prof., Head of the Department of Urology

R. G Biktimirov

A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: rafbik@yandex.ru
Ph.D., Associate Professor at the Department of Urology and Andrology, IPPE

A. G Martov

A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: martovalex@mail.ru
Dr.Med.Sci., Prof., Head of Department of Urology and Andrology, IPPE

F. A Sevryukov

Clinical Hospital at Nizhny Novgorod Railway Station of JSC «RZD»

Email: fedor_sevrukov@mail.ru
Dr.Med.Sci., Prof., Head of the Department of Urology

A. B Novikov

Multidisciplinary Medical Center of the Bank of Russia

Email: novikov-ab@yandex.ru
Head of the Department of Urology

A. E Sanzharov

Federal Scientific and Clinical Center, FMBA of Russia

Email: sanzh@mail.ru
Head of the Department of Urology

V. P Sergeev

A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: garivas@yandex.ru
Head of the Department of Oncourology

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