Combination flexible and rigid endoscopy in treating staghorn calculi.
Ge Guangcheng1,Li Zhongxing1,Feng Rui1,Jia Yuejun1,Zhong Wen2
1Department of Urology, The Second People's Hospital of Zhenjiang, Zhenjiang 212000 China; 2Department of Urology, The First Affiliated Hospital of Guangzhou Medical University
Abstract：Objective: To analyze the results and complications of combinated flexible ureteroscopic lithotripsy (FUL) and percutaneous nephrolithotomy (PCNL) in treating staghorn calculi, and to explore the ideal treatment choice for staghorn calculi. Methods: 30 patients with staghorn calculi received intervention. In the first session, PCNL was performed, and most partition of staghorn calculi were extracted from F18-24 percutaneous tract. In the second session, FUL was performed to extract the residual stones, second look PCNL was administrated if necessary. Results: All 30 patients were managed successfully, the stone free rate is 93.3% 1 month after the first operation. 2 patients had residual stones ranged 0.8-1.2 cm that located in lower pole and middle pole, respectively. 3 (10%) patients had postoperative fever, and 2 (6.7%) patients required transfusion. No other severe complication was noted. Conclusions: The staged procedures combinated PCNL and FUL that debulking most partition of staghorn calculi in the first stage PCNL and followed by FUL as the supplementary treatment modality for residual stones in second session, can get a high SFR, and reduce the need for multiple tracts in PCNL procedures therefore minimize the related complications. In conclusion, it maybe an ideal treatment choice for staghorn calculi.
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