Open Surgery in the Management of Multiple and Staghorn Kidney Stones: Its Role in the Era of Minimally Invasive Techniques

Ismail, Mohamed; Ghobashy, S.; El-Leithy, T.; El-Baz, Ahmad M G; Roushdy, M.; Alkholy, Amr A; Kalesh, Talaat A El; Mehena, A.

doi:10.3834/uij.1939-4810.2008.10.04

Cited by 1 publication

(9 citation statements)

References 14 publications

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“…In our review, four treatment modalities were identified for complex renal stones, all of which were surgical interventions [13][14][15][16][17][18][19][20][21][22][23]. These included percutaneous nephrolithotomy (PCNL), open surgery, laparoscopic surgery, and retrograde intrarenal surgery (RIRS).…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Nine out of the 11 reviewed articles employed PCNL as the primary treatment modality for staghorn calculi and other complex stones, representing 72% (1,089 patients, 1120 renal units) of the total patients reviewed [13,14,[16][17][18][19][20][21]23]. Of these PCNL procedures, a single tract was utilised in 30.2% (329 cases) of patients, double tracts in 25.6% (279 cases), three or more tracts in 18.4% (200 cases), and the number of tracts not specified in 25.8% (281 cases).…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Open surgery had the highest rate at 30.75% (104 patients), followed by PCNL at 20.9% (227 patients), laparoscopic surgery at 16.63% (six patients), and RIRS at 4.8% (three patients). Six of the studies reported an average hospital stay of 5.08 days for patients undergoing the PCNL procedure [13,[16][17][18]20,21] The number of complications for each type of procedure is represented in the table, with each complication expressed as a percentage of the total number of patients with complications (340 patients).…”

Section: Complicationsmentioning

confidence: 99%

“…Our analysis of the reviewed articles revealed that PCNL was the most commonly used procedure for treating complex stones and staghorn calculi (72%) [13,14,[16][17][18][19][20][21]23], followed by open surgery (21.1%) [16,17,20,21,23]. The significant use of open surgery may be attributed to the cost implications of less invasive procedures and the expertise of surgeons in certain African countries.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Seven of the studies reviewed reported the clinical presentation of patients with staghorn stones [ 13 , 16 , 17 , 18 , 20 , 21 , 22 ]. The commonest clinical presentation seen was Urinary Tract Infection (UTI), reported in all seven studies.…”

Section: Reviewmentioning

confidence: 99%

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Current Practices and Challenges in the Management of Complex Renal Stones in Africa: A Scoping Review

Abdulrasheed,

George,

Ayobami-Ojo

et al. 2024

Cureus

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This study reviews the challenges and management strategies for complex renal stones in Africa. Historically viewed as infection or struvite stones, recent studies highlight diverse compositions of staghorn stones. These complex stones pose significant risks, including recurrent urinary tract infections and renal impairment. In the past, conservative management of staghorn stones was associated with high morbidity; thus, surgical intervention was necessary for complete eradication. While percutaneous nephrolithotomy (PCNL) remains the standard, it carries notable risks, leading to a shift towards minimally invasive techniques. This study reviews challenges and management practices for complex renal stones and staghorn calculi in African countries, evaluating stone-free rates and associated complications.A scoping review of the literature, following the Preferred Reporting Items for Systematic Reviews and Metaanalysis guidelines, was performed. A systematic search was conducted in PubMed, African Journal Online (AJOL) and Google Scholar, yielding 1,101 articles, but only 11 articles satisfied the inclusion criteria.The study included 1,513 patients with 1,582 renal units, predominantly male (67.2%) with an average age of 40.7 years. Percutaneous nephrolithotomy (PCNL) was the primary treatment for the majority (71.3%), followed by open surgery (21.9%), laparoscopic surgery (4.1%), and retrograde intrarenal surgery (RIRS) (2.7%). The stone clearance rates for PCNL, open surgery, laparoscopic pyelolithotomy, and RIRS were 82.8%, 83.7%, 100%, and 92.8%, respectively. Stone sizes ranged between 22 and 80 mm, with 66% being staghorn stones. Complication rates were highest for open surgery (30.8%) and lowest for RIRS (4.7%).Despite PCNL being the global standard, African studies still indicate a high reliance on open surgery, likely due to healthcare infrastructure, resource availability and socioeconomic factors. Enhancing access to urological care and addressing healthcare disparities are imperative for improving staghorn stone management in Africa.

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