OBJECTIVE:To present our centre's experience in the surgical treatment of lithiasis in patients with horseshoe kidney.
MATERIAL AND METHODS: From October 2007 to March 2011 we treated 10 patients with renal lithiasis in their horseshoe kidneys. Retrospectively, we reviewed the symptoms, medical and surgical history, the characteristics of the stones (size, location, composition) and treatments that were carried out. In all the cases, the study was carried out by CT, with volume reconstruction and with an angiographic study. A percutaneous nephrolithotomy (PCNL) or an endoscopic retrograde intrarrenal surgery (RIRS) was carried out, depending on the size and location of the stone.
RESULTS: Three percutaneous nephrolithotomies were carried out (2 on staghorn lithiasis stones, 1 pseudocoraliform stone) with a combined rigid and flexible single-access nephroscopy. In one case there was haemorrhage that required treatment by selective embolization. In the rest, RIRS was carried out, all with stones < 30mm in their greatest diameter without any complications. The mean surgical times were 120 (60-180) minutes for the percutaneous route and of 105 (65-160) minutes for the retrograde route. In all the cases the treatment achieved a complete elimination of the stones or remains of less than 5mm.
CONCLUSIONS: The treatment of renal lithiasis in horseshoe kidneys is complex, given their peculiar anatomy. The usual surgical techniques can be reproduced in these cases with good results. We opt for PCNL in complete staghorn stone and pseudocoraiform stones, whereas RIRS is a valid option in cases with stones < 3cm.
Written by:
Palmero JL, Amoros A, Ramírez M, Pastor JC, Benedicto A. Are you the author?
Servicio de Urología, Unidad de Litotricia y Endourología, Hospital Universitario de La Ribera, Valencia, España.
Reference: Actas Urol Esp. 2011 Dec 16. Epub ahead of print.
doi: 10.1016/j.acuro.2011.10.005
PubMed Abstract
PMID: 22178345
Article in English, Spanish.
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