Combination laparoscopy and nephrolithotomy technique in the same session in patients with complete staghorn stones and poor performance status: case series in a single center with long-term follow-up
Abstract
BACKGROUND: The management of complete staghorn stones remains a challenge for urologists, owing to the high stone burden, low stone free rate, and high rate of complications. Hence, we aimed to evaluate the outcomes of a technique involving combination laparoscopy and nephrolithotomy in the same session in patient with complete staghorn stones and poor performance status.
METHODS: We retrospectively evaluated seven patients with complete staghorn stones who underwent a combination of laparoscopy and nephrolithotomy in the same session in our center between December 2016 and October 2019. The surgical technique was as follows. Through a four-port transperitoneal laparoscopic approach, the kidney was mobilized after complete dissection of the renal pedicle. The renal pelvis was then incised with a cold scalpel. A nephroscope was inserted into the renal collecting system through both a laparoscopic port and the renal pelvis incision. This method enabled visualization of and access to almost all calyces for clearing the stones from the affected kidneys in a hand-assisted manner which a hand was inserted in the peritoneal cavity. The outcome data included the stone-free rate, short-term and long-term complication rates, and stone recurrence rate.
RESULTS: The stone free rate was 85.70% (6/7). No patients had sepsis or required blood transfusion perioperatively, and no major short-term complications occurred. After 24.00 (15.00, 48.00) months' follow-up, no patients had long-term…
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