Abstract

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

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