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Preoperative imaging in staghorn calculi, planning and decision making in management of staghorn calculi

Asian Journal of Urology 2020年第2期7卷 87-93页

作者： Ilan Klein Jorge Gutierrez-Aceves Department of Urology Wake Forest University Baptist Medical CenterWinston-SalemNCUSA

Objective:Staghorn calculi present a particular and challenging entity of stone *** is associated with lower stone-free rates and higher complication rates compared to non-staghorn *** this review we looked for the most relevant data on preoperative imaging and access planning to help decision making for percutaneous surgery with this complex ***:We conducted a PubMed search of publications in the past 2 decades that include relevant information on the planning for management of staghorn ***-contrast computerized tomography(NCCT)is indeed the standard imaging tool for percutaneous nephrolithotomy(PCNL);additional tools such as three-dimensional computed tomography(CT)reconstruction of the staghorn calculus may help plan access in complex *** guided percutaneous access may be considered for staghorn stones when planning upper pole access in kidney malposition or complex intrarenal anatomy or with complex body *** doppler ultrasound and real-time virtual sonography can *** technologies to improve kidney access such as Uro Dyna-CT or electromagnetic sensor have been reported,but have not shown utilization in staghorn *** morphometry-based prediction algorithms may predict the number of tract(s)and stage(s)for PCNL *** pole access can be equally effective as upper pole when planning for staghorn and complex stones,with significantly less complications rate;Stone-Tract length-Obstruction-Number of involved calyces-Essence of stone density(STONE)nephrolithometry seems to be the best system to predict outcomes of PCNL in staghorn *** is a growing trend of endoscopic combined intrarenal surgery(ECIRS)in concordance with PCNL to treat larger *** management of staghorn calculi is an undesired option,but can be an alternative for a carefully selected group of high-risk ***:Staghorn stones may lead to deterioration of renal function and l

关键词： Staghorn stone Preoperative planning Imaging kidney access

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