PNL for Staghorn Stones Gives Satisfactory Results
Percutaneous nephrolithotomy (PNL) for staghorn kidney stones provides satisfactory long-term functional results, researchers concluded.
In a study of 122 patients (mean age 47.6 years; range 5-74 years) who underwent 126 PNL procedures and had at least one year of follow-up, Ahmed R. El-Nahas, MD, of Mansoura Urology and Nephrology Center in Mansoura, Egypt, showed that 91.5% of kidneys showed stable or improved glomerular filtration rate (GFR) after a mean follow-up of 3.5 years, according to an online report in BJU International.
Perioperative complications occurred in 28 procedures (22%). Among 71 stone-free kidneys, 18 (25%) developed stone recurrence. Pre- and post-operative renograms were obtained for 71 patients. At the last follow-up, differential GFR was stable in 53 (74.5%), improved in 12 (17%), and deteriorated in six (8.5%). Among patients with deteriorated kidney function, three had undergone embolization to control severe bleeding, one had secondary ureteropelvic junction obstruction, and one had recurrent stone obstructing the kidney.
Of 55 kidneys with residuals at the start of follow-up, 36 (65%) demonstrated growth of these residuals, the authors reported.
The authors concluded that long-term follow-up of patients who undergo PNL for staghorn stones is mandatory, especially for those with residual stones.