title: [Single procedure treatment of complex nephrolithiasis: about a modern series of anatrophic nephrolithotomy].
abstract: OBJECTIVE
  Advances in endourology have significantly reduced indications of open surgery in the treatment of staghorn calculi. However, in our experience, open surgery is still the treatment of choice in some cases. This study presents the results of a series of selected patients and discusses the results in terms of efficacy and morbidity.
  
  
  METHODS
  A cohort of 26 patients underwent anatrophic nephrolithotomy by lombotomy to treat a complex staghorn calculus.
  
  
  RESULTS
  The mean stone size was 68,5mm, 70% were complete staghorn calculi. The operative time was 100minutes. Blood loss was 225mL, with a postoperative transfusion rate of 15.4%. The hospital stay was 8.4 days. The stone free rate following the procedure was 92%. The creatinine clearance (MDRD) at 3 months was improved from 5.9mL/min/m(2) on average over the entire series.
  
  
  CONCLUSIONS
  There are clearly still indications for open surgery in staghorn stones management, with good results in this contemporary series on both stone removal and nephronic preservation. Yet, it appears that this technique is no longer taught.
  
  
  METHODS
  5.
authors.affiliation: Département d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 1, avenue J.-Pouilhès, 31059 Toulouse, France. Electronic address: pierrelunardi@hotmail.fr.
authors.forename: P
authors.initials: P
authors.lastname: Lunardi
authors.affiliation: Service d'urologie, HEGP-Necker, Paris-XV, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: M O
authors.initials: MO
authors.lastname: Timsit
authors.affiliation: Département d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 1, avenue J.-Pouilhès, 31059 Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Roumiguie
authors.affiliation: Service d'urologie, HEGP-Necker, Paris-XV, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Dariane
authors.affiliation: Service d'urologie, centre hospitalier de Polynésie française, Tahiti, Polynésie française.
authors.forename: K
authors.initials: K
authors.lastname: N'Guyen
authors.affiliation: Département d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 1, avenue J.-Pouilhès, 31059 Toulouse, France.
authors.forename: J B
authors.initials: JB
authors.lastname: Beauval
authors.affiliation: Service d'urologie, centre hospitalier de Polynésie française, Tahiti, Polynésie française.
authors.forename: S
authors.initials: S
authors.lastname: Leroux
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007670:Kidney Calices; D008297:Male; D012189:Retrospective Studies; D013520:Urologic Surgical Procedures / Q000379:methods
keywords: Anatrophic nephrolithotomy; Calcul coralliforme; Laparotomie; Laparotomy; Lithiase rénale; Néphrolithotomie bivalve; Renal lithiasis; Staghorn calculi