Laparoscopy Assisted Percutaneous Nephrolithotomy in Patients with Ectopic Pelvic Kidneys: Experience in 24 Patients

Abstract

Introduction: Pelvic ectopic kidney with stones is relatively an uncommon urological abnormality. Limited literature is available for surgical management of such cases. Because of abnormal anatomy, endoscopic surgery can be a challenging task. Aim: To evaluate the safety and efficacy of laparoscopy-assisted Percutaneous Nephrolithotomy (PCNL) in patients with pelvic ectopic kidneys with nephrolithiasis. Materials and Methods: This was a retrospective study conducted from May 2015 to July 2019. All patients with pelvic ectopic kidneys with nephrolithiasis were screened and patients who underwent laparoscopy-assisted PCNL were enrolled. The variables studied were age, sex, side of the pelvic kidney, stone size, tract size, duration of surgery, duration of nephrostomy tube, duration of abdominal drain and duration of hospital stay. Complications reported or observed during intraoperative or postoperative period were also noted. Descriptive statistics was used. Results: The mean age of the patient was 36.5±9.3 (Mean±SD) years. Fifteen patients were males and nine were females. The mean size of stone was 17.9±3.2 (Mean±SD) mm and in 17 (70.8%) patients, stone was located on right side. The mean tract size was 23.1±1.2 (Mean±SD) French and the mean duration of surgery was 127.8±12.5 (Mean±SD) minutes. The stone clearance rate was 100%. The mean duration of nephrostomy tube, abdominal drain, and hospital stay was 2.2±0.4 (Mean±SD) days, 3.5±0.8 (Mean±SD) days, and 3.8±1.0 (Mean±SD) days, respectively. Two patients reported complications (ileus and fever). Conclusion: In patients with pelvic ectopic kidney with stones, laparoscopy-assisted PCNL is safe and effective procedure. Further prospective, randomised studies with large sample size are required to clearly establish the role of laparoscopyassisted PCNL.

Keywords

• anomalous kidney
• calculus
• kidney stone