Asian Journal of Urology (Apr 2020)

Percutaneous nephrolithotomy for staghorn calculi: Troubleshooting and managing complications

  • Nariman Gadzhiev,
  • Vigen Malkhasyan,
  • Gagik Akopyan,
  • Sergei Petrov,
  • Francis Jefferson,
  • Zhamshid Okhunov

Journal volume & issue
Vol. 7, no. 2
pp. 139 – 148

Abstract

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Staghorn calculi comprise a unique subset of complex kidney stone disease. Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for staghorn stones. Despite continuous refinements to the technique and instrumentation of PCNL, these stones remain a troublesome challenge for endourologists and are associated with a higher rate of perioperative complications than that for non-staghorn stones. Common and notable intraoperative complications include bleeding, renal collecting system injury, injury of visceral organs, pulmonary complications, thromboembolic complications, extrarenal stone migration, and misplacement of the nephrostomy tube. Postoperative complications include infection and urosepsis, bleeding, persistent nephrocutaneous urine leakage, infundibular stenosis, and death. In this review, we report recommendations regarding troubleshooting measures that can be used to identify and characterize these complications. Additionally, we include information regarding management strategies for complications associated with PCNL for staghorn calculi. Keywords: Percutaneous nephrolithotomy, Staghorn, Complications, Management, Urolithiasis