Introduction. Anatrophic nephrolithotomy is a procedure in which a parenchymal incision is made in an intersegmental plane, allowing removal of large renal. We offered the patient staged open anatrophic nephrolithotomy. Results. Operative time was minutes. Blood loss was cc. requiring one. The anatrophic nephrolithotomy described by Smith and Boyce is an excellent method of preserving a maximum number of functioning nephrons by minimizing .

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Eighty-eight renal units were assed, 43 submitted to PNL and 45 to conventional surgery. Patients with staghorn calculi in a nonfunctioning kidney are candidates for nephrectomy, and the procedure also may be considered if the stone-laden kidney has irrevocably poor function providing the contralateral renal unit has satisfactory function.

Find articles by Ramaiah Keshavamurthy. In our experience, open surgery still plays a role in the treatment of staghorn stone disease, even if rarely required. Median IQR estimated blood loss was 75 ml. The mean SD kidney size was Table of Contents Alerts.

J Clin Diagn Res. All 13 patients received ml of intravenous mannitol. Follow-up at 1 mo demonstrated no change in renal function as estimated by creatinine clearance. Baseline characteristics and investigations: Laparoscopy is needed in complex staghorn stones that would necessitate multiple, simultaneous or subsequent, percutaneous renal accesses [ 3 — 10 ].


The mean SD in situ cold ischemia time was The mean operative time was minute with a mean warm ischemia time of 31 minute. In this review we assess functional results after anatrophic nephrolithotomy.

This patient had bilateral staghorn calculi and underwent bilateral AN. June 29, First decision: In order to control those issues nephrolitgotomy to preserve the maximal number of functional nephrons they described the anatrophic nephrotomy and calyrhaphy.

Estimated glomerular filtration rate; Tc99m MAG3: Smith et al[ 10 ] identified some factors that may contribute for perpetuating renal inflammatory process after stone surgery: Renal function was preserved with a serum creatinine of 1.

This may be related to nephron injury during nephrotomy and parenchymal closure or to ischemic injury. Please review our privacy policy. Patient comorbidities, direct injury by kidney puncture and tract dilation, ischemia, inflammation and fibrosis are some of the possible mechanisms implicated on renal function deterioration.

Open-Access Policy of This Article. Anatrophic Nephrolithotomy AN as proposed by Smith and Boyce in is the most preferred technique for such surgery [ 2 ].

Anatrophic Nephrolithotomy in the Management of Large Staghorn Calculi – A Single Centre Experience

nephrolitjotomy We present our experience of AN in our centre wherein we have performed more than procedures for renal calculi. Jaffery AH et al. Patients were discharged after drain removal and residual calculi was seen in two patients needing ESWL. Standard Multilenght stent was placed in the ureter, and a Malecot tube was left in pelvis.


Between April and JulyAN was done in 14 renal units in 13 patients at our institute which is a tertiary care referral urological center.

A doble J 6 Fr. Author information Article notes Copyright and License information Disclaimer. Case Reports in Urology.

The mean SD time to clamp nephrostomy clamping was 7.

Indication to Open Anatrophic Nephrolithotomy in the Twenty-First Century: A Case Report

Several modifications of the classical approach have been described usually without defining the intersegmental plane[ 14 – 19 ]. In our experience the impossibility to perform a laparoscopic nephrolithofomy represents the most common indication for open surgery. One patient underwent ipsilateral PNL four years back, one patient came for clearance post PNL and one patient underwent pyelolithotomy 7 years back. The aim of the procedure was to remove all calculi and fragments, improving urinary drainage, eradicating infections, and preserving renal function.