Anatrophic nephrolithotomy performed via open surgery involves incising the renal parenchyma along an avascular plane to remove a large, complex renal stone. Although excellent stone free rates can be achieved with anl there are some drawbacks that may be of concern. Anatrophic nephrolithotomy is a procedure in which a parenchymal incision is made in an intersegmental plane, allowing removal of large. If so, you and your doctor can explore other options, like open surgery that requires a.
Developments of the technique in the era of minimally invasive surgery. Anatrophic nephrolithotomy in the management of large staghorn. Is there still a need for openlaparoscopic surgery for. Read laparoscopic anatrophic nephrolithotomy for managing large staghorn calculi, bju international on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. With advances in endourology, open stone surgery for staghorn calculi has markedly diminished. In expert hands, anatrophic nephrolithotomy is an effective procedure, which spares renal function. We evaluated the feasibility and efficacy of the retroperitoneal laparoscopic approach for the management of large staghorn renal calculi. Anatrophic nephrolithotomy is a procedure in which a parenchymal incision is made in an intersegmental plane. Robotic pyelolithotomy and robotic nephrolithotomy are safe and reasonable alternatives to percutaneous nephrolithotomy for removing renal stones in select patients. Laparoscopic anatrophic nephrolithotomy lan has been described as an effective, safe and reproducible method in experienced centers, however, it presents higher rates of complications compared to pcnl, and higher renal function loss 727% in the affected kidney but could be less invasive and. Read robotic extended pyelolithotomy for complete staghorn calculus, journal of robotic surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.
The first use of laparoscopic anatrophic nephrolithotomy for a staghorn calculi in a patient was reported by deger et al. Nephrolithotomy is the gold standard for removing oversized or complex stones. Postoperative renal outcomes of patients receiving. Laparoscopic nephrolithotomy in a patient with crossed fused. Patients and methods laparoscopic transperitoneal anatrophic nephrolithotomy. In particular, robotic pyelolithotomy allows the removal of stones without transgressing the parenchyma, reducing potential bleeding and nephron loss. Anatrophic nephrolithotomy anl is a valid and useful alternative for conventional staghorn calculi excision. The role of robotic assisted surgery in contemporary urolithiasis management is in its infancy. A retrospective study was conducted for patients who underwent anl between january 1995 and december 2016. The advent of laparoscopic stone removing procedures has further reduced the need to perform open surgery, even anatrophic nephrolithotomy 310.
Authors simforoosh n, radfar mh, nouralizadeh a, tabibi a, basiri a, mohsen ziaee sa, sarhangnejad r, abedinzadeh m. Laparoscopic pyeloplasty combined with pyelolithotomy and flexible nephroscopy was performed in ten patients, laparoscopic pyeloplasty with pyelolithotomy and endoscopicassisted nephrolithotomy was performed in two. Robotic extended pyelolithotomy for complete staghorn calculus. Bilateral laparoscopic anatrophic nephrolithotomy for. Laparoscopic nephrolithotomy has unique advantages, including the ability to cut the renal cortex directly, thereby removing the calculus completely. To report the clinical efficacy and intermediateterm functional outcome after laparoscopic anatrophic nephrolithotomy lan as an alternative treatment modality for complete staghorn renal stone. Pdf anatrophic nephrolithotomy is a urological procedure t hat is. However, there is scarce information on its role for managing large staghorn stones. Pdf laparoscopic vs open anatrophic nephrolithotomy operative.
We determined the feasibility of performing laparoscopic anatrophic nephrolithotomy in a survival porcine model. Laparoscopic nephrolithotomy in a patient with crossed. Pdf anatrophic nephrolithotomy for the management of large. Review on renal recovery after anatrophic nephrolithotomy. Ureteroscopy assistedretrogradenephrostomyuarn after anatrophicnephrolithotomy takashikawahara,1,2 hirokiito,1,2 hideyukiterao,1 yoshitakekato,1 takehikoogawa,2. Health, general calculi, urinary care and treatment laparoscopic surgery analysis comparative analysis laparoscopy percutaneous nephrostomy urinary. Laparoscopic anatrophic nephrolithotomy a feasible option. The mean total gfr rised from arterial clamp was released and reapplied to allow suture of bleeding vessels with figureof8 sutures with vicryl. The role of robotic surgery in the management of renal. The feasibility of laparoscopic anatrophic nephrolithotomy for managing the staghorn calculi was described. Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones. To assess the indications and outcomes of an in the modern era. From 2007 to 2010, we performed eight anatrophic laparoscopic nephrolithotomies in adult patients with staghorn renal calculus.
Advances in endourology have greatly reduced indications to open surgery in the treatment of staghorn kidney stones. Pdf on apr 11, 2017, gomezregalado francisco and others published laparoscopic vs open anatrophic nephrolithotomy operative outcomes and. Comparison of safety and efficacy of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in patients with large renal pelvic stones. In recent years, percutaneous nephrolithotomy pcnl has been widely used in treating kidney stones and has achieved good efficacy. Laparoscopic anatrophic nephrolithotomy request pdf. Robotassisted anatrophic nephrolithotomy with renal. Laparoscopic transperitoneal anatrophic nephrolithotomy was used to. Traditionally perfomed via open technique with a flank incision, anatrophic nephrolithotomy was associated with significant morbidites of pain, longer hospital stay and incisional hernias. Laparoscopic anatrophic nephrolithotomy lan has been described as an effective, safe and reproducible method in experienced centers, however, it presents higher rates of. The objective of this study is to assess our technique of anatrophic nephrolithotomy, with decreased renal ischemia and reduced patient morbidity.
Laparoscopic anatrophic nephrolithotomy springerlink. Additionally, a nephrostomy drain using a 16 fr foley catheter was placed in two patients. Laparoscopic anatrophic nephrolithotomy is feasible and a promising alternative for patients with large staghorn calculus, which offers complete stone clearance in a single operative session with minimal morbidity and well preserved renal function. Laparoscopic vs open anatrophic nephrolithotomy operative. Laparoscopic anatrophic nephrolithotomy is a promising alternative for patients who are candidates for open surgery, with an acceptable stonefree rate. Pdf on mar 1, 2010, akbar nouralizadeh and others published bilateral laparoscopic anatrophic nephrolithotomy for managing staghorn. In the present study we assessed the feasibility of laparoscopic anatrophic nephrolithotomy lan as an alternative technique for managing large staghorn renal stones, to offer another minimally invasive approach in. Anatrophic nephrolithotomy is a major surgery frequently performed for a.
Patient was discharged free of stone on fifth postoperative day. Data were retrieved from the taiwan national health insurance research database. Laparoscopic and robotassisted surgery in the management of urinary lithiasis. B after clamping, repeated injections of ice slush can cover the entire kidney surface. To present our initial experience of applying laparoendoscopic singlesite surgery less nephrolithotomy in the treatment of renal calculi.
The great limitation of laparoscopic surgery resides in patients comorbid conditions such as. Ureteroscopyassistedretrogradenephrostomyuarnafter. Morbidity related to intraoperative and postoperative complications is one of them. A comparison between laparoendoscopic singlesite and. The mainstay in the management of renal tract calculi remains ureterorenoscopy urs, extracorporeal shock wave lithotripsy eswl and percutaneous nephrolithotomy pcnl. Achieving laparoscopic anamorphic nephrolithotomy a reasonably stone free rate with one procedure.
As previously addressed pnl is the standard treatment for staghorn stones. Article in journal of endourology endourological society december 2012 with 8. Laparoscopic anatrophic nephrolithotomy for managing large. Pdf bilateral laparoscopic anatrophic nephrolithotomy for. Laparoscopic treatment is well accepted in renal surgery. Laparoscopic anatrophic nephrolithotomy for management of staghorn renal calculi. Although the laparoscopic techniques for stone treatment are quite challenging, it is both feasible and safe. Laparoscopic anatrophic nephrolithotomy for management of. Comparative study of laparoscopic pyelolithotomy versus.
Retroperitoneal laparoscopic anatrophic nephrolithotomy. Robotassisted anatrophic nephrolithotomy a clamping of renal artery with laparoscopic bag placed around the kidney along with laparoscopic sponge at the base to facilitate suction of melting ice. To evaluate the longterm changes of selective renal function after anatrophic nephrolithotomy anl. What is the role of anatrophic nephrostolithotomy in the. Laparoscopic surgery has been used to replicate different open surgeries used for ureteral and renal stones management. Renal function is preserved and with emergence of laparoscopy and robotics, postoperative stay is minimized with expedited recovery and. Inclusion criteria were availability of preoperative and followup 1 year or more radioisotopic renal scans.
Simforoosh n, radfar mh, nouralizadeh a, tabibi a, basiri a, mohsen ziaee sa, sarhangnejad r, abedinzadeh m. Robotic assisted laparoscopic ureterolithotomy ralu, robotic assisted laparoscopic pyelolithotomy rpl with or without concurrent pyeloplasty and robotic assisted laparoscopic anatrophic nephrolithotomy have all been described for complex stones, often refractory to conventional endourological techniques. For stone disease, it can duplicate open surgical techniques such as pyelolithotomy, pyeloplasty, anatrophic nephrolithotomy, caliceal diverticulectomy and nephrectomy. Anatrophic nephrolithotomy in the management of large. Anatrophic nehrolithotomy is an option in cases where, less invasive procedures such as percutaneous nephrolithotomy pcnl and extracorporeal shock wave lithotripsy swl cannot achieve complete clearance in a reasonable number of sessions. Indication to open anatrophic nephrolithotomy in the. Laparoscopic anatrophic nephrolithotomy for managing large staghorn calculi. Original research, report by canadian urological association journal cuaj. Laparoscopic anatrophic nephrolithotomy a feasible option in. Laparoscopic anatrophic nephrolithotomy is feasible and a promising alternative for patients with large staghorn calculus, which offers complete stone clearance in a single operative session with minimal morbidity and wellpreserved renal function.
In august 2010 and april 2012, the less nephrolithotomy technique was applied to treat two patients with a renal calculus. A double j stent and percutaneous drain was left postoperatively in all patients. Laparoscopic anatrophic an attempt to preserve renal. The role of laparoscopic surgery for renal calculi. During the period from jan 1, 1998, to dec 31, 2012, there were 2549 and 21654 patients who underwent pyelolithotomy and pcnl, respectively. The aim of this populationbased cohort study was to explore postoperative renal outcomes of patients receiving pyelolithotomy versus percutaneous nephrolithotomy pcnl. The role of laparoscopic surgery as a minimally invasive method to manage staghorn renal calculi was formerly discussed only in limited articles. Anatrophic nephrolithotomy an as proposed by smith and boyce in 1968 is the most preferred technique for such surgery. A total of 8 patients undergo to laparoscopic anatrophic nephrolithotomy, patients mean age was 42.
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