Percutaneous nephrolithotomy of horseshoe kidney: Our institutional experience

Abstract

Purpose:To review our success in PCNL for managing large horse shoe kidney stones as primary treatment.Method:Between 2012 and 2016, a total of 23patients (24 renal units) underwent percutaneous renal surgery for stone dieses in horseshoe kidneys. Indications were HSK with stone more than 1 cm in size and failed ESWL.Results:Mean age was 35.60 ± 10.10 years out of which 18 were males and 5 females. One patient had stone in both kidneys. Mean stone size was 22.03 ± 10.33 mm. Access site was upper calyceal and subcostal in all patients. In 2 patients an extra middle calyceal puncture were used for total clearance (8.69%). Mean operation time was 67.22 ± 7.63 minutes. One patient with staghorn stone was converted to open surgery because of inaccessibility of the stone and complexity of the renal calyceal system. Post operatively, 2 renal units with residual stone more than 8mm were cleared with ESWL. Complete clearance was achieved in 21 renal units with PCNL (87.50%). There was no significant intra operative complication. Post operatively 2 patients developed fever which was treated conservatively(clavien grade I).Conclusion:PCNL can be recommended as first line of management in the treatment of horseshoe kidneys with large stone burden considering its higher clearance rate and minimal complications.

Open Pyelolithotomy in a Pelvic Ectopic Kidney: Case Report and Current Literature Review

“…ESWL is still a valuable modality in minimally invasive stone surgery for anomalous kidneys. However, the results remain unsatisfactory, especially for larger stones [9]. The utilization of laparoscopically guided transperitoneal PCNL for this condition has been reported before.…”

Alternating Biplanar Fluoroscopy in Percutaneous Nephrostomy to Approach Stones in Patients With Horseshoe Kidney: An Institutional Experience

“…On the other hand, a percutaneous approach to tackle the stone in the horseshoe kidney is advised if SWL fails or for bigger stones [3]. By reviewing the horseshoe kidneys' PCN/PCNL results in some previous studies, the success rate was considered if all stones are removed or if the residual stone was less than 4 mm, which collectively ranged between 50%-87.5% (Table 2) [4][5][6][7][8][9]. Our study shows a comparable stone-free rate of 66.6% with a desirable profile of minimal complications.…”