Minimally invasive percutaneous nephrolithotomy for upper urinary tract calculi in transplanted kidneys

Authors

  • Zhaohui He,

    1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, and Department of Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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  • Xun Li,

    1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, and Department of Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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  • Lizhong Chen,

    1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, and Department of Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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  • Guohua Zeng,

    1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, and Department of Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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  • Jian Yuan

    1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, and Department of Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Li Xun, Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong, China.
e-mail: gdgzlx@zien.com

Abstract

Authors from China describe their experience with percutaneous nephrolithotomy for upper urinary tract calculi in transplanted kidneys. They confirm that it is a suitable way to treat such stones, and suggest it as initial therapy for stones other than those in the middle or lower calyx, particularly if they are small stones.

OBJECTIVE

To report our experience with minimally invasive percutaneous nephrolithotomy (mPCNL) for upper urinary tract (UUT) calculi in transplanted kidneys.

PATIENTS AND METHODS

Between August 2002 and June 2006, seven patients (mean age 40.7 years) with UUT stones in transplanted kidneys (including one staghorn, two pelvic and four ureteric stones) were treated by mPCNL. A 16 F peel-away sheath was placed as the percutaneous access port and a 8.5/11.5 F nephroscope or a 8/9.8 F ureteroscope was used for manipulation. Every 2–3 months during the follow-up, patients had their serum urea, creatinine and uric acid measured, with urine culture and ultrasonography.

RESULTS

All patients were rendered stone-free at one mPCNL procedure, with no complications during or after surgery. The mean (range) operative duration was 53 (20–100) min and the mean haemoglobin decrease was 0.55 (0.2–1.2) g/dL. At a mean (range) follow-up of 23 (3–48) months renal allograft function was stable in all patients and no recurrence of stone was detected.

CONCLUSIONS

mPCNL is safe and effective for managing calculi in transplanted kidneys, and it can be the initial therapy for most cases of UUT stones in transplanted kidneys, except for simple and small stones in the middle or lower calyx.

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