![]() Single-session PCNL is normally selected for large renal With staghorn renal stone and concurrent urinary tract infection It remains controversial which procedures are best for patients Urosepsis after upper urinary tractĮndoscopic surgery is a life-threatening complication andĬonsidered to be associated with high intrapelvic pressure and Significantly increased compared with that occurring in this Severe bleeding and post-operative sepsis ( 5).ĭuring PCNL for staghorn calculi, blood loss is Procedure with a comparatively higher stone-free rate (SFR), itīears a considerable risk of serious complications, including Or laparoscopic surgery may be a treatment option ( 4). ![]() Urology (EAU) guidelines, most complex stones, including partialĪnd complete staghorn stones, should be approached primarily withĪpproaches are not likely to be successful, or if multipleĮndourological approaches have been performed unsuccessfully open ![]() Guidelines, percutaneous nephrolithotomy (PCNL) should be theįirst-line treatment for most patients with staghorn calculi In the 20 American Urological Association (AUA) Limited the open surgical nephrolithotomy to cases with complex Of endourological, ureteroscopic and percutaneous techniques have The success rates and widespread application The management of staghorn renal stones remains aĬhallenge in urology. In conclusion, RLP with prolonged renal posterior lower segment incision is an effective and safe procedure for patients with staghorn renal stones and concurrent UTI, and its feasible application as a single‑session monotherapy is particularly convenient considering the financial and medical situation, as well as the patients' preference. No severe complications, including urine leakage, sepsis, residual stones requiring auxiliary procedures, were noted and there were no circumstances requiring further surgical intervention in any of the patients. Mild post‑operative complications (Grade I or II) occurred in 6 patients, including temporary and constant elevated body temperature (>38.5˚C). The stone‑free rate was 100% at 3 days and at 6 months. The mean change of serum creatinine levels between pre‑operative baseline and post‑operative day 3 or post‑operative month 6 was 6.0☒0.03 or ‑4.5☑5.13 µmol/l, respectively. The mean hemoglobin drop on day 3 following surgery was 0.5☐.38 g/dl and there was no requirement for blood transfusion in any patient. The mean operation time, warm ischemia time and post‑operative hospital stay were 114.4☑2.09 min, 28.1±4.23 min and 5.8☑.42 days, respectively. The mean age was 57.0☑0.81 years (age range, 40‑74 years) and the mean calculus size was 3.3☐.79 cm. All patients (18 females and 10 males) successfully underwent the procedures and there was no conversion to open surgery in any case. UTI was confirmed by laboratory tests with or without radiographic evidence by an experienced urologist. All patients were examined pre‑operatively by urinary ultrasonography, computed tomography or intravenous urography. Routine laboratory tests were performed and the patients received broad‑spectrum intravenous antibiotics from at least 3 days prior to the operation. Patients with staghorn renal stone and concurrent urinary tract infection (UTI) who underwent RLP with prolonged renal posterior lower segment incision as the primary, one‑session treatment at our institution between March 2014 and December 2017 were retrospectively reviewed. ![]() The present study evaluated the effectiveness and safety of the removal of unilateral staghorn renal stones with concurrent infections by retroperitoneal laparoscopic pyelolithotomy (RLP) with prolonged renal posterior lower segment incision.
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