THE EFFICACY AND SAFETY OF MINI-PERCUTANEOUS NEPHROLITHOTRIPSY IN THE TREATMENT OF LARGE AND STAGHORN STONES OF THE KIDNEY

Abstract

Introduction. Large (>2 cm) and Staghorn kidney stones are severe forms of: nephrolithiasis. Percutaneous nephrolithotomy is first line in treatment of large kidney stones, according to the recommendations of the American and European associations of urology. In the modern literature is the high frequency of complications after percutaneous nephrolithotripsy, renal bleeding is the most serious of which. Many different methods of treatment with application of nephroscope small diameters in order to achieve acceptable high performance, but with fewer complications. Objective. We used a mini-percutaneous nephrolithotomy in patients with large and Staghorn kidney stones. Materials and methods. From February 2014 to January 2015, one surgeon of our center made 32 mini-percutaneous nephrolithotripsy in patients with large and Staghorn kidney stones. Criteria of effective treatment was the complete removal of stones or the presence of residual calculus size <3 mm. Postoperative complications were evaluated according to modified Clavien classification. Results. Age ranged from 25 to 67 years. Women was 62.5 percent. The average stone size was 32.4 (21- 62) mm. The average time of surgery was 67.5 (20-200) min. Stone free was 87.5 %. The complication rate was 9.4%. 3.1% - leakage of urine (Clavien 3b), 6.3% - urinary tract infection (Clavien 2). Conclusion. Mini-percutaneous nephrolithotomy is an effective and safe treatment of patients with large and Staghorn kidney stones. It has a minimal complication rate and there is not much blood loss.