Mini incision open nephrolithotomy for renal calculus: Colworths experience.

Author Omodu OJ
Co-Author Omodu CVO
DOI https://ww

Country : Nigeria
Subject :

Keywords : nephrolithotomy, incision, calculus.

Abstract

Background

Due to advances in endourology, there have been lesser indications to open surgery in the management of renal calculi thus reducing hospital stay. Nonetheless, mini access incisions of 4 to 6cm using open nephrolithotomy have reduced both operating times and hospital durations in our experience.

Aim

This study aimed to demonstrate the efficacy of minimal incision in open nephrolithotomy to reduce patient hospital stay, early ambulation and postoperative pain.

Patients and Methods

This is a prospective study of open nephrolithotomy procedures on renal calculus’ with staghorns while minimally incising. Between 2019 and 2022, 14 patients underwent open nephrolithotomy and they were laterally positioned on the left or right depending on the site of surgery.

Minimal subcostal incisions of 6 to 8 cm combined with muscle cutting and a splitting technique were used to access the gerota fascia. Information obtained included age, gender, diagnosis, procedure, duration of surgery, length of hospital stays, and pain threshold. Subjective pain outcome was assessed using the visual pain analogue score (VAS).

Instruments included a combination of paediatric and adult operating instruments, c-arm fluoroscopy, diathermy, operating loops and anaesthetic machine with patient monitors. Some patients were administered epidural anaesthesia.

Results

During the period of study, 14 procedures were performed on patients with an average age of 44.07 years. The average incision length was 6.42 cm and the mean operation time was 135.5 mins. Additionally, the mean post operative stay was 3.2 days.

There were 9 males and 5 females. 1 patient had staghorn calculi, 3 had multiple renal stones and 10 had solitary stones in one of the calyxes.

Conclusion

Mini incision open nephrolithotomy is a safe and effective technique however, there is a lack of manpower for percutaneous nephrolithotomy. Favourable outcomes and scar formations can be achieved without many technical difficulties.

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