Abstract
Introduction. Open surgical anatrophic nephrolithotomy (ANL) had been the standard treatment for large renal calculi prior to the development of endoscopic devices and endoscopic techniques. A previous report described the efficacy of ureteroscopy-assisted retrograde nephrostomy (UARN) and presented a case of renal calculi successfully treated with UARN during percutaneous nephrolithotomy (PCNL) in a patient after ANL. Case Presentation. A 61-year-old male with left renal calculi was referred for further treatment. The patient was placed under general and epidural anesthesia, in a Galdakao-modified Valdivia position. A flexible ureteroscope (URS) was inserted, and a Lawson retrograde nephrostomy puncture wire was advanced into the flexible URS. The puncture wire then followed the route from the renal pelvis to the exit skin. Calculus fragmentation was undertaken using a pneumatic lithotripter. Conclusions. UARN for PCNL was therefore found to be a safe, effective, and appropriate treatment for a patient presenting with renal calculi after undergoing ANL.
Highlights
Open surgical anatrophic nephrolithotomy (ANL) had been the standard treatment for large renal calculi prior to the development of endoscopic devices and endoscopic techniques
A previous report described the efficacy of ureteroscopyassisted retrograde nephrostomy (UARN) and presented a case of renal calculi successfully treated with UARN during percutaneous nephrolithotomy (PCNL) in a patient after ANL
UARN for PCNL was found to be a safe, effective, and appropriate treatment for a patient presenting with renal calculi after undergoing ANL
Summary
Staghorn calculi are branched and generally infected stones that occupy a large portion of the renal collecting system [1]. Management of staghorn calculus remains a challenge even using endoscopic devices and techniques [2]. Open surgical anatrophic nephrolithotomy (ANL) had been the standard treatment of large renal stones prior to the development of endoscopic procedures. The progressive use of laparoscopic techniques has led to the use of laparoscopic ANL [2,3,4]. Goodwin et al first reported percutaneous renal access in 1955 [5]. Percutaneous nephrolithotomy (PCNL) was developed, and PCNL became the standard procedure for large renal stones [6].
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