Safety and Efficacy of Minimally Invasive Percutaneous Nephrolithotomy in Treatment of Calculi in Horseshoe Kidneys

Abstract

OBJECTIVE: To evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) in horseshoe kidneys (HKs) with calculi. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.