Retroperitoneoscopy Technique-Assisted Percutaneous Nephrolithotomy for Complexity Horseshoe Kidney with Renal Stones

Urol Int. 2016;97(3):285-291. doi: 10.1159/000446120. Epub 2016 Jul 23.

Abstract

Objective: To assess the safety and efficacy of retroperitoneoscopy technique-assisted percutaneous nephrolithotomy (PCNL) used in the treatment of complexity horseshoe kidney (HSK) with renal stones.

Methods: Between January 2012 and April 2015, 5 patients with renal stones in complexity HSK underwent retroperitoneoscopy technique-assisted PCNL. The perioperative data analyzed, included operation time, blood loss, incidence of complication rate, the stone-free rate (SFR), and so on.

Results: All the patients successfully completed the operation without need for an open surgery. The mean operative time in which this procedure was done was 77.5 ± 20.6 min, the mean hemoglobin that was reduced was 2.5 ± 0.8 g/dl, the mean time to remove nephrostomy tube and retroperitoneal tube were 3.0 ± 1.0, 3.5 ± 1.0 days, respectively. The mean hospital stay was 7.0 ± 1.5 days. The SFR of all the patients was 80% (4/5). One patient who had residual stones (6 × 5 mm) in the middle pole underwent additional shock wave lithotripsy after the operation and no serious perioperative complications were noticed. Study limitations include small sample size and short follow-up time.

Conclusions: Retroperitoneoscopy technique-assisted PCNL is a feasible, safe, and an effective alternative to laparoscopic pyelolithotomy for treating complexity HSK with renal stones, especially in a situation where the HSK is tightly wrapped by the surrounding organs.

MeSH terms

  • Adult
  • Female
  • Fused Kidney / complications*
  • Fused Kidney / surgery*
  • Humans
  • Kidney Calculi / complications*
  • Kidney Calculi / surgery*
  • Laparoscopy*
  • Male
  • Nephrostomy, Percutaneous / methods*
  • Retroperitoneal Space