title: [Percutaneous nephrolitholapaxy combined with extracorporeal shockwave lithotripsy in the treatment of staghorn lithiasis].
abstract: From December, 1988 to July, 1989, 41 patients with renal or juxtapyelic ureteral calculi were submitted to percutaneous litholapaxy (PCN) at the Stone Center of the Hermanos Amerijeiras Hospital in Havana. This series comprise our early experience utilizing this procedure. PCN was initially limited to pelvic and juxtapyelic ureteric calculi with dilated renal cavities. It was subsequently used in combination with extracorporeal lithotripsy (ESWL) in the treatment of staghorn stones. The present study analyzed the results achieved with PCN in 30 patients with staghorn calculi; 21 (70%) incomplete staghorns and 9 (30%) complete staghorns. Posteriorly, 6 additional borderline staghorns were completely removed by PCN and are not included in the present study. PCN was performed to reduce stone mass and for placement of a large renal drain to permit subsequent ESWL. At two months following treatment, 86.6% of the patients were completely stone-free. The remaining 13.4% with stone remnants presented anatomic and functional renal conditions that allow us to predict complete elimination within a short period of time. Since 6 months had not elapsed in these cases, these were not considered as residual fragments. One patient presented massive absorption of fluids. This was the only observed major and non-lethal complication. Episodes of fever were observed in 23% post-PCN. No patient presented severe sepsis. In our view, PCN combined with ESWL is one of the currently available therapeutic options in the treatment of staghorn calculi. This approach permits adequate resolution of cases that would have otherwise required surgery.
authors.affiliation: Centro de Tratamiento de la Litiasis Urinaria, Hospital Clinico Quirúrgico Hermanos Ameijeiras, La Habana, Cuba.
authors.forename: E
authors.initials: E
authors.lastname: Larrea Masvidal
authors.forename: C
authors.initials: C
authors.lastname: García Serrano
authors.forename: M
authors.initials: M
authors.lastname: Castillo Rodríguez
authors.forename: D
authors.initials: D
authors.lastname: Hernández Silverio
authors.forename: J
authors.initials: J
authors.lastname: Casals Armada
authors.forename: C
authors.initials: C
authors.lastname: Valdés Gómez
authors.forename: D
authors.initials: D
authors.lastname: Báez Hernández
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004724:Endoscopy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008096:Lithotripsy; D008297:Male
vernacular_title: Nefrolitotricia percutánea asociada a litotricia extracorpórea por ondas de choque en el tratamiento de la litiasis coraliforme.