Experiencia inicial nefrolitotomía percutánea, posición de Valdivia modificada para el tratamiento quirúrgico en pacientes con litiasis renal

Abstract

Background

Renal lithiasis is a very common pathology that has been described since Hippocrates. Its etiopathogenesis involves different theories on formation that include saturation, oversaturation, crystal nucleation, crystal growth, epitaxis, matrix, crystallization inhibitors, epidemiologic aspects, and heredity. Compared with classic lumbotomy, percutaneous nephrolithotomy is a less aggressive technique facilitating kidney stone treatment. Reduced hospital stay, low analgesic use, and a shorter recovery period make this a well-accepted surgical technique by patients and it is considered the first treatment option in many cases.

Aims

To present the experience at our institution with the modified version of the previously described technique.

Material and methods

All surgical notes on percutaneous nephrolithotomies in the modified Valdivia position performed within the time frame of January to August 2014 were reviewed.

Results

The mean age of the patients was 42 years. Of the 10 patients included in the study, 7 were men and 3 were women. Five of the patients presented with staghorn stones, 2 with pyelic stones, and the rest with pyelic and calyceal stones. Stone size ranged from 2 to 7 cm. A total of 2 (28.6%) stones were in the lower portion of the collecting system, 7 (64%) were in the middle portion, and one (7.1%) was in the upper portion. Estimated surgery duration was a mean of 120.5 min. The complication rate (Clavien-Dindo: I-IV) was 20%, one patient presented with bleeding that was controlled, and 80% of the patients were stone free.

Conclusions

In our experience, percutaneous nephrolithotomy with the modified Valdivia technique is a safe and effective option with a high success rate, anesthesiological advantages, and few complications.