scholarly journals Lumbar plexopathy as a complication of percutaneous nephrolithotomy in a horseshoe kidney

2015 ◽  
Vol 9 (1-2) ◽  
pp. 78 ◽  
Author(s):  
Andrea Gail Lantz ◽  
R. John D'A Honey
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Psoas Muscle ◽  
Horseshoe Kidney ◽  
Vascular Supply ◽  
Stone Disease ◽  
Laparoscopic Pyelolithotomy ◽  
Staghorn Calculus ◽  
Leg Weakness ◽  
Independent Ambulation ◽  
Collecting System

Treatment of nephrolithiasis in horseshoe kidneys can be challenging due to anomalies in renal position, collecting system anatomy and vascular supply. We report on a patient who was referred after a failed percutaneous nephrolithotomy for a left moiety staghorn calculus in a horseshoe kidney. Two punctures had been performed involving upper and middle posterior calyces. Both were very medially placed and inadvertently traversed the psoas muscle, resulting in lumbar plexopathy with permanent deficit. This complication presented postoperatively with left leg weakness, paresthesia, and pain which impaired independent ambulation. The patient went on to be successfully treated for her stone disease with robotic-assisted laparoscopic pyelolithotomy.

scholarly journals Percutaneous Nephrolithotomy and Horseshoe Kidneys

2020 ◽  
Vol 3 (2) ◽  
pp. 343-346
Author(s):  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parash Mani Shrestha ◽  
Biswa Raj Joshi
Keyword(s):  
Retrospective Study ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Ureteropelvic Junction Obstruction ◽  
Horseshoe Kidney ◽  
Standard Technique ◽  
Stone Clearance ◽  
Percutaneous Access ◽  
Staghorn Calculus ◽  
Collecting System

Introduction: The most common fusion anomaly, horseshoe kidney, is associated with vascular anomalies, malrotation, anterior displacement of the collecting system, superior insertion of ureter into the pelvis, and a higher rate of ureteropelvic junction obstruction; thus increasing the chances of nephrolithiasis. We present our experience with percutaneous nephrolithotomy in this anomaly.Materials and Methods: A retrospective study of all the percutaneous nephrolithotomy performed by standard technique within four years at Bir Hospital was made. A comparison was made with similar cases with the anatomically normal location of the kidney. Intraoperative variables were recorded and postoperative stonefree status and complications were evaluated.Results: Six hundred and twenty-seven patients out of 691 who had undergone percutaneous nephrolithotomy in this period were included. Patients with nephrolithiasis in horseshoe kidney were younger, the incidence of multiple stones was more; without full staghorn calculus and occupying fewer calyces. Upper pole access was easier, a stone clearance of 85.42 % was achieved with no major complications in the horseshoe kidney.Conclusions: Percutaneous access and nephrolithotomy are safe in horseshoe kidney with a good stone clearance rate.

PERCUTANEOUS NEPHROLITHOTOMY IN HORSESHOE KIDNEY STONE DISEASE

2008 ◽  
Vol 179 (4S) ◽  
pp. 501-501
Author(s):  
I Atilla Aridogan ◽  
Volkan Izol ◽  
Yildirim Bayazit ◽  
Zuhtu Tansug ◽  
Sinan Zeren
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Kidney Stone ◽  
Horseshoe Kidney ◽  
Stone Disease ◽  
Kidney Stone Disease

scholarly journals Evaluation of laparoscopic retroperitoneal approach for management of various renal calculi

2018 ◽  
Vol 5 (7) ◽  
pp. 2449
Author(s):  
Rudramani . ◽  
Vikas Singh ◽  
Shesh Kumar ◽  
Anil Kumar ◽  
Shailendra Kumar ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Multimodality Treatment ◽  
Renal Calculi ◽  
Retroperitoneal Approach ◽  
Retrograde Intrarenal Surgery ◽  
Laparoscopic Pyelolithotomy ◽  
Different Types ◽  
Staghorn Calculus ◽  
Mean Size ◽  
Laparoscopic Experience

Background: Despite the availability of Multimodality treatment for management of renal calculi as ESWL (Extra Corporeal Shock Wave Lithotripsy), PCNL (Percutaneous nephrolithotomy), URS (Ureterorenoscopy), RIRS (Retrograde intrarenal surgery) and open surgery and Percutaneous nephrolithotomy (PCNL), the gold standard, laparoscopic pyelolithotomy is an alternative treatment modality as long as the operator has adequate laparoscopic experience. Evaluation of Laparoscopic retroperitoneal approach for management of various renal calculi must be done to get the efficacy of the procedure according to the calculus and renal morphology.Methods: Laparoscopic retroperitoneal pyelolithotomy/nephrolithotomy was performed on 58 patients with various renal calculi patterns viz. solitary pelvic calculus, staghorn calculus, staghorn calculus with calyceal and isolated calyceal calculi. Extended pyelolithotomy, Gilvernet’s technique were used as per the need.Results: Out of the 58 cases with renal calculi, solitary renal pelvic stones (n=23; 39.7%) were most common followed by staghorn (n=11; 19% Mean size 4.40±1.17 cm) and isolated caliceal stones (n=9; 15.5% with Mean size2.21±0.25 cm) respectively. There were 15 (25.9%) cases with mixed stones (11 cases solitary renal pelvic and isolated caliceal stones and 4 cases had staghorn and isolated caliceal stones). Stone clearance was 93.3 to 100%.Conclusions: laparoscopic retroperitoneal approach is a useful modality for clearance of renal calculi of different types with minimum complications and a high success rate. However, the technique seems to have a limited role for isolated caliceal stones where direct or C-arm guided nephrolithotomy can be performed for better clearance of stones.

Asymptomatic emphysematous pyelitis—a rare clinical entity

2021 ◽  
Vol 14 (1) ◽  
pp. e235421
Author(s):  
Hannah Thorman ◽  
Nikita R Bhatt ◽  
Sona Kapoor ◽  
Azad Hawizy
Keyword(s):  
Renal Function ◽  
Percutaneous Nephrolithotomy ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Distal Ureter ◽  
Asymptomatic Woman ◽  
Significant Volume ◽  
Staghorn Calculus ◽  
The Right ◽  
Collecting System

A 62-year-old asymptomatic woman with diabetes was referred to the urology department from nephrology due to deterioration in renal function with accompanied right-sided hydronephrosis on ultrasound. CT imaging subsequently revealed a right-sided staghorn calculus and a significant volume of gas in the right collecting system from the kidney to the distal ureter, in keeping with emphysematous pyelitis. She was admitted and managed with antibiotics and insertion of right nephrostomy in the first instance, followed by percutaneous nephrolithotomy to definitively manage the stone. The patient remained asymptomatic throughout the process.

scholarly journals Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098313
Author(s):  
Tie Mao ◽  
Na Wei ◽  
Jing Yu ◽  
Yinghui Lu
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Efficacy And Safety ◽  
Complementary Treatment ◽  
Laparoscopic Pyelolithotomy ◽  
Stone Free Rate ◽  
Free Rate

Background We aimed to compare the efficacy and safety of laparoscopic pyelolithotomy (LPL) versus percutaneous nephrolithotomy (PCNL) for treating renal stones larger than 2 cm. Methods We searched the PubMed, Embase, Web of Science, SinoMed, and Chinese National Knowledge Infrastructure databases for studies that compared the surgical outcomes of LPL and PCNL. We conducted a meta-analysis of the retrieved studies, expressed as weighted mean difference or risk ratios with 95% confidence intervals. Results We included 25 studies (1831 patients). LPL was associated with a significantly higher stone-free rate, lower rates of blood loss, complementary treatment, blood transfusion, and complications, and less reduction in hemoglobin level compared with PCNL. LPL and PCNL were similar in terms of duration of hospital stay, conversion rate, changes in glomerular filtration rate and creatinine level, and mean time of postoperative analgesia. However, LPL was associated with a longer operation time than PCNL. Conclusion LPL appears to be more effective and safer than PCNL in patients with large renal stones, by increasing the stone-free rate and reducing blood loss, complementary treatment, blood transfusion, and complications compared with PCNL. LPL may thus be a useful modality for treating patients with large renal stones.

Unilateral Triplication of the Collecting System in a Horseshoe Kidney

1983 ◽  
Vol 130 (3) ◽  
pp. 533-534 ◽  
Author(s):  
Dov Pode ◽  
Amos Shapiro ◽  
Pinchas Lebensart
Keyword(s):  
Horseshoe Kidney ◽  
Collecting System

Comparison between different techniques for management of renal stones in horseshoe kidneys

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abdel Fattah Mohammed Aggour ◽  
Mohamed Kotb Ahmed Tolba ◽  
Abdelrahman nazmy abbas hatata
Keyword(s):  
Horseshoe Kidney ◽  
Renal Stones ◽  
Operative Management ◽  
Flexible Ureteroscopy ◽  
Stone Clearance ◽  
Stone Burden ◽  
Laparoscopic Pyelolithotomy ◽  
Almost All ◽  
Laparoscopic Assisted ◽  
Operating Surgeon

Abstract Objective To report the operative management , intra and post operative complications and subsequent stone-free rates of patients with urolithiasis in a horseshoe kidneys. Materials and Methods We retrospectively reviewed all patients presenting to our centre with a horseshoe kidney and urolithiasis over a 20-year period. The stone burden, surgical management, complications and stone clearance rates were recorded. Results In all, 80 patients with urolithiasis in horseshoe kidney were treated. Percutaneous nephrolithotomy (PCNL) was used in 28 patients. 12 patients had laparoscopic assisted PCNL , 8 had flexible ureteroscopy and 18 had laparoscopic pyelolithotomy . PCNL was used for large stones = (mean digitized surface area= 614.32 mm 2 ) and required one to four stages to achieve an overall stone clearance rate of 88%. Stones were cleared at one sitting in 77% of PCNL procedures. only 33% of patients treated with flexible ureteroscopy was cleared from stones in one session and surprisingly, 89% of patients treated with laparoscopic pyelolithotomy was stone free after one session Complications were minimal, with 15% minor and 3% major complications in the PCNL group only.. Conclusions Appropriate management of urolithiasis within the horseshoe kidney depends not only on stone burden, but also on stone location, calyceal configuration and malrotation. Stones can be cleared successfully in almost all patients providing that all techniques are available to the operating surgeon.

scholarly journals Study of variations in the pelvicalyceal system of kidney and its clinical importance

2013 ◽  
Vol 8 (3) ◽  
pp. 17-21 ◽  
Author(s):  
PR Wadekar ◽  
SD Gangane
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Clinical Importance ◽  
Percutaneous Nephrostomy ◽  
Clinical Implications ◽  
Clear Understanding ◽  
Medical Sciences ◽  
Pelvicalyceal System ◽  
Collecting System

Objective The present study has been undertaken to study the variations in renal pelvicalyceal system, to compare them with previous studies and to find their clinical implications. Materials and Methods A total of 100 kidneys (from 50 cadavers) were included in this study. The following parameters were measured 1)Lower Infundibular length, 2)Infundibular Width – Lower Infundibular Width (LIW), Middle Infundibular Width (MIW), Upper Infundibular Width (UIW), 3)Number of minor calyces and 4)Number of major calyces. Results The obtained data showed that there were numerous variations not only in the numbers of calyces of kidneys but also in the infundibular length and width. Conclusion Developments in endourology, percutaneous nephrolithotomy and techniques for retrograde percutaneous nephrostomy have rekindled interest in the anatomy of the renal collecting system. To perform these procedures safely and efficiently it is essential to have a clear understanding of pelvicalyceal anatomy and its variations. Thus the in-depth knowledge of pelvicalyceal anatomy will be of immense value to the clinicians of related specialties. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-3, 17-21 DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8681

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