Safety and efficacy of minimally invasive percutaneous nephrolithotomy in treatment of calculi in horseshoe kidneys.
OBJECTIVE
To evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) in horseshoe kidneys (HKs) with calculi.


METHODS
From 2006 to 2012, 35 renal units in 32 patients with calculi in HKs underwent MPCNL. Patients and stone characteristics, stone-free rates (SFR), and complications were evaluated. The composition of the stones obtained from operation was also analyzed by infrared spectroscopy.


RESULTS
The average age of patients was 38.2±7.3 years (range 14-72). The mean stone burden was 657±510.9 mm(2) (range 134.7-2460.1). The mean operative time was 93.4±17.6 minutes (53-152). The most popular access site was upper pole access (35/42, 83.3%). The SFR after initial MPCNL was 82.9% (29/35 renal units). Second-stage MPCNL was performed in 5 renal units, with a 91.4% (32/35 renal units) final SFR. Minor complications (Clavien grades I and II) were seen in six patients, and urosepsis requiring intensive care unit management in one (Clavien grade IVa). All were treated successfully.


CONCLUSIONS
MPCNL is a safe and effective treatment modality in HK stones with acceptable results, which was compatible to a normal anatomy kidney. However, further studies with a larger sample size are required.
Guangdong Key Laboratory of Urology, Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .
Wenqi
W
Wu
Zhenhua
Z
Zhao
Hanliang
H
Zhu
Dong
D
Yang
Lili
L
Ou
Yeping
Y
Liang
Zhijian
Z
Zhao
Guohua
G
Zeng
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D012449:Safety; D018805:Sepsis / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult