The use of laparoscopic pyelolithotomy in obese patients with staghorn nephrolithiasis

Kochkin A.D., Sevryukov F.A., Sorokin D.A., Karpuhin I.V., Puchkin A.B., Semenychev D.V., Abramov D.V.

In spite of significant success in treatment of the urolithiasis, extraction of the staghorn stones in obese patients is a major clinical problem. Role of the laparoscopic approach in operative treatment of these patients is not clear. The aim of this work was to analyze retrospectively our first experience in treatment of obese patients with staghorn kidney stones using the laparoscopic pyelolithotomy. The analysis was performed in 15 patients. No intraoperative complications were registered. There was no need in blood transfusion. Infectious complications (including sepsis) were not evident. Postoperatively we could observe a formation of the urinoma related to the migration of nephrostomy tube in one female patient. This complication was managed by means of the re-nephrostomy. Median (IQR) of the postoperative in-hospital stay was 9 (7; 11) days. Residual secondary roentgen-negative stone was detected in a lower calyx of the kidney in one female patient, which has underwent laparscopic pyelolithotomy due to staghorn roentgen-positive stone. Our first experience with laparoscopic pyelolithotomy has showed the perspectives of the method and its efficacy and safety. In some cases this approach could be considered as alternative in treatment of patients with staghorn urolithiasis.

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