title: Long-term results of percutaneous nephrolithotomy for treatment of staghorn stones.
abstract: OBJECTIVE
  • To study long-term results of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones.
  
  
  METHODS
  • The records of patients who underwent PNL for staghorn stones between January 1998 and January 2008 were retrospectively reviewed. • Patients who completed follow-up for one year or more were included. Follow-up with KUB and renal ultrasonography were performed every 3-6 months. • Renal radioisotopic scan was performed for patients who had already undergone this study before doing PNL.
  
  
  RESULTS
  • The study included 122 patients (69 male and 53 female) with mean age 47.6 ± 14.5 years (5-74). They underwent 126 PNL. • Perioperative complications were encountered in 28 procedures (22%). The mean period of follow-up was 3.5 ± 2.3 years (1-11.3). Among 71 stone-free kidneys, 18 (25%) developed stone recurrence. Of 55 kidneys with residuals at the start of follow-up, 36 (65%) showed growth of these residuals. • Preoperative and postoperative renograms were performed for 71 patients. • At the last follow-up, differential GFR was stable in 53 (74.5%), improved in 12 (17%) and deteriorated in 6 (8.5%). Among patients with deteriorated renal function, 3 had undergone embolization to control severe bleeding, one developed secondary UPJO, and one had recurrent stone obstructing the kidney.
  
  
  CONCLUSIONS
  • Long-term functional results of PNL for staghorn stones are satisfactory as 91.5% of kidneys showed stable or improved GFR. Long-term follow-up is mandatory especially for patients with residual stones.
authors.affiliation: Urology department, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt. ar_el_nahas@yahoo.com
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: El-Nahas
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Eraky
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shokeir
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Shoma
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: El-Assmy
authors.forename: Nasr A
authors.initials: NA
authors.lastname: El-Tabey
authors.forename: Hamdy A
authors.initials: HA
authors.lastname: El-Kappany
authors.forename: Mahmoud R
authors.initials: MR
authors.lastname: El-Kenawy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000503:physiopathology / Q000601:surgery*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult