Combination therapy in the treatment of patients with staghorn calculi.
The treatment of patients with staghorn calculi remains a challenging problem. Combination therapy using percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy has been recommended as the best option for most patients. Using this technique, 10 (83%) of 12 renal units with partial or complete staghorn calculi were rendered stone-free, with no significant septic episodes or serious complications. Blood transfusion was necessary in three patients. "Sandwich" therapy using initial percutaneous debulking followed by extracorporeal shock wave lithotripsy and/or "second-look" nephroscopy offers patients a high likelihood of achieving a stone-free state while avoiding the morbidity and lengthy recovery associated with open surgery.
Gerber
G S
GS
Department of Surgery, University of Chicago Pritzker School of Medicine, Illinois 60637, USA.
D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000000981:diagnostic imaging / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D017616:Magnesium Compounds / Q000737:chemistry; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D010710:Phosphates / Q000737:chemistry; D011859:Radiography; D000069877:Struvite; D016896:Treatment Outcome
D017616:Magnesium Compounds; D010710:Phosphates; D000069877:Struvite