title: Percutaneous nephrolithotomy among patients with renal anomalies: patient characteristics and outcomes; a subgroup analysis of the clinical research office of the endourological society global percutaneous nephrolithotomy study.
abstract: OBJECTIVE
  This study compared the characteristics and outcomes of percutaneous nephrolithotomy (PCNL) in patients with and without renal malformations using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database.
  
  
  METHODS
  The CROES PCNL Global Study collected prospective data for consecutive patients who were treated with PCNL at centers around the world during 1 year. Patient characteristics, operative data, and outcomes of PCNL in patients with renal anomalies and those with normal kidneys were compared.
  
  
  RESULTS
  Of 5542 patients whose renal anatomy was recorded, 202 (3.6%) patients had a renal malformation. The most frequent anomalies were horseshoe kidneys (1.8%) and malrotated kidneys (1.3%). The prone position was the most frequently used position for patients with renal anomalies as was upper pole puncture. PCNL achieved stone-free rates of 76.6% in patients with anomalous kidneys and 76.2% in those with normal kidneys. The frequency of complications was similar in the two groups. Median operative time was significantly longer (87 min vs 75 min, P=0.037), and access for PCNL was unsuccessful in significantly more patients (5% vs 1.7%, P=0.001) in whom renal anomalies were present.
  
  
  CONCLUSIONS
  In patients undergoing PCNL, the presence of renal malformation is likely to extend operative time. Stone-free rates as well as incidence of complications after PCNL are similar irrespective of the presence of renal anomalies.
authors.affiliation: Department of Urology, Fredericia Hospital, University of Southern Denmark, Fredericia, Denmark.
authors.forename: Palle Jörn
authors.initials: PJ
authors.lastname: Osther
authors.forename: Hassan
authors.initials: H
authors.lastname: Razvi
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liatsikos
authors.forename: Timothy
authors.initials: T
authors.lastname: Averch
authors.forename: Alfonso
authors.initials: A
authors.lastname: Crisci
authors.forename: Juan Lòpez
authors.initials: JL
authors.lastname: Garcia
authors.forename: Arup
authors.initials: A
authors.lastname: Mandal
authors.forename: Jean
authors.initials: J
authors.lastname: de la Rosette
mesh_terms: D017677:Age Distribution; D035843:Biomedical Research; D005260:Female; D006801:Humans; D038622:Internationality; D007430:Intraoperative Care; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery*; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D056888:Patient Positioning; D012955:Societies, Medical; D016896:Treatment Outcome; D014572:Urology