[The staghorn calculus: anatrophic nephrolithotomy versus percutaneous litholapxy and extracorporeal shockwave therapy versus extracorporeal shockwave lithotripsy monotherapy. A report of over 6 years' experience].
From 1982 to December 1987, 71 with incomplete (C4 by Rocco) and 37 with complete (C5 by Rocco) staghorn calculi underwent anatrophic nephrolithotomy (AN; n = 29), or combined percutaneous nephrostolithotomy and ESWL (PCNL + ESWL; n = 21), or ESWL monotherapy without or with preoperative JJ stenting (n = 37/21). The patients with incomplete staghorn calculi (C4) and preoperative ureteral stenting were free of stones after 6 months in 15 of 17 cases (88%), which is comparable to our results with AN (90%) and combined PCNL + ESWL (85%). ESWL without JJ stenting were free of stones in only 52%. The treatment of infected C4 calculi with JJ stenting was especially successful (92%). Complete staghorn calculi (C5) represented the best results after AN (78%) and combined PCNL + ESWL (75%), in contrast to ESWL without JJ stenting (44%). Four patients with C5 calculi were treated with ESWL and preoperative stenting, three of them were free of stones after 6 months. For incomplete staghorn calculi (C4), ESWL monotherapy with JJ stenting seems to be a justifiable noninvasive method which offers excellent results in stone elimination (88%), with lower costs than AN or PCNL + ESWL. More invasive procedures should be reserved for complete staghorn calculi.
Recker
F
F
Urologische Klinik, Universitätsspital Zürich, Schweiz.
Konstantinidis
K
K
Jaeger
P
P
Knönagel
H
H
Alund
G
G
Hauri
D
D
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*
Der Nierenbeckenausgussstein: Anatrophe Nephrolithotomie versus perkutane Litholapaxie und ESWL versus ESWL Monotherapie. Ein Bericht über 6 Jahre Erfahrung.