title: Retroperitoneal laparoscopic anatrophic nephrolithotomy for large staghorn calculi.
abstract: OBJECTIVE
  Treatment of staghorn calculus is challenging. We evaluated the feasibility and efficacy of the retroperitoneal laparoscopic approach for the management of large staghorn renal calculi.
  
  
  METHODS
  Patients with staghorn renal calculi unsuitable for percutaneous nephrolithotomy were analyzed. They underwent retroperitoneal laparoscopic anatrophic nephrolithotomy, involving control of the renal artery, stone removal through a nephrotomy incision on the Brodel's line and closure with continuous sutures.
  
  
  RESULTS
  A total of 11 patients with renal stones were included in the present study. Mean patient age was 55 years (range 42-68) and stone size was 52 mm (range 43-61). Warm ischemia time and operative duration were 31 (range 23-38) and 139 min (range 105-160), respectively. No blood transfusion was needed during or after operation. An 8-mm residual calculus remained in the lower calyces in one patient who was successfully treated by using shock wave lithotripsy. Intravenous pyelogram after surgery showed a functional corresponding renal unit, with an improvement in obstruction in all patients.
  
  
  CONCLUSIONS
  Retroperitoneal laparoscopic technique can be applied for patients who are candidates for anatrophic nephrolithotomy. Larger studies with a longer follow up are needed to confirm these findings.
authors.affiliation: Department of Urology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
authors.forename: Linyu
authors.initials: L
authors.lastname: Zhou
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xuan
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.forename: Jun
authors.initials: J
authors.lastname: Xiao
authors.forename: Xiaocheng
authors.initials: X
authors.lastname: Dong
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.forename: Yuping
authors.initials: Y
authors.lastname: Zhu
authors.forename: Kui
authors.initials: K
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012187:Retroperitoneal Space / Q000601:surgery