A huge staghorn renal stone: Is there still a need for open surgery to protect against further damage to the kidney? A case report

Dharmendra Kumar Pipal; Saurabh Jain; Prakash Biswas

doi:10.5339/qmj.2023.30

ISSN: 0253-8253
EISSN: 2227-0426

oa A huge staghorn renal stone: Is there still a need for open surgery to protect against further damage to the kidney? A case report
Authors: Dharmendra Kumar Pipal¹, Saurabh Jain², Prakash Biswas¹
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Affiliations: ¹ Department of General Surgery, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India Email: [email protected] ORCID iD: https://orcid.org/0000-0002-4162-8617 ² Arihant Hospital, Bhilwara, Rajasthan, India
Source: Qatar Medical Journal, Volume 2023, Issue 4, Jan 2024,
DOI: https://doi.org/10.5339/qmj.2023.30
- Received: 29 May 2023
- Accepted: 07 September 2023
- Published online: 26 October 2023

Abstract

Introduction: Staghorn calculi (SC) occupy the renal pelvis and calyces and are common in females linked to repeated urinary tract infections (UTIs). Judicious surgery planning reduces the chance of further damage to the kidney due to renal SCs. Open stone surgery (OSS) is one of the various operative techniques to remove such huge stones with one operative intervention and protect the kidney from ongoing functional damage.

Case Report: A 47-year-old male patient presented with right-sided renal colic pain, and on further investigations, he was diagnosed with a large renal stone responsible for substantial renal function impairment on the same side. The SC measured 8 × 4 cm with another stone in the lower calyx. thinner parenchyma, and only 16% relative function. Therefore, open surgery was selected over less invasive approaches because multiple lithotripsy (ESWL) sittings may have been required in less invasive options.

Discussion: SCs, which can be complete or partial, often result in renal impairment. Hence, it is crucial to implement a proactive therapeutic approach that includes a thorough evaluation of the stone’s size and position, the patient’s choice, and institutional capacity. Complete elimination of SCs is preferred to maintain maximal renal function. Based on clinical, technical, and socioeconomic considerations, open pyelolithotomy or OSS was chosen over percutaneous nephrolithotomy for SC removal in the discussed case.

Conclusion: The ability to remove large stones in a single intervention with open pyelolithotomy has been very effective due to its distinctive clinical presentation and pathological abnormalities.

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A huge staghorn renal stone: Is there still a need for open surgery to protect against further damage to the kidney? A case report

Qatar Medical Journal 2023, 30 (2024); https://doi.org/10.5339/qmj.2023.30

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Article Type: Research Article

Keyword(s): extracorporeal shock wave lithotripsy, open stone surgery, percutaneous nephrolithotomy, retrograde intrarenal surgery and staghorn calculus

oa A huge staghorn renal stone: Is there still a need for open surgery to protect against further damage to the kidney? A case report

Abstract

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