Anis Hussain Jaffery, Muhammad Zubair, Aziz Abdullah.
Anatrophic Nephrolithotomy in the management of large staghorn renal calculi.
Pak J Surg Jan ;24(2):110-2.

Objective: To assess the efficacy of anatrophic nephrolithotomy in the management of large staghorn renal calculi. Design & Duration: Retrospective case series from January 2001 to December 2007. Setting: Ziauddin University Hospital, Jamal Noor Hospital, Liaquat National Hospital, and some other private hospitals where the authors practice. Patients: One hundred patients with renal staghorn calculi undergoing anatrophic nephrolithotomy. Methodology: All the patients were preoperatively evaluated, and were operated via lumbar approach, through the bed of 12th rib. Cold ischemia was achieved by packing the perirenal space with sterile crushed normal saline. The calculus was removed and complete stone clearance was checked by direct visualization and later on by radiology. The patient was followed-up in the out-patients department for 12 weeks. Results: Out of 100 patients, 56 were male and 44 female, with a mean age of 41.33 years. The mean operating time was 76.93 mins. and mean cold ischemia time was 22.44 mins. Seven patients had secondary haemorrhage; four required required angioembolization. In one patient peroperative nephrectomy had to be carried out. Twelve patients required blood transfusion. Conclusion: Anatrophic nephrolithotomy is a valid option to achieve complete stone clearance in large staghorn renal calculi.

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