Partial Nephrectomy for Stone Disease

Abstract

The results of 227 partial nephrectomies for stone were reviewed. Radiologically visible calcification remaining in the kidney at the end of the operation increased the risk of further stone formation. Ipsilateral and contralateral true recurrence rates after partial nephrectomy were the same, and increased with time up to 34% at 20 years. Ipsilateral recurrence rates after partial nephrectomy were half those found in a similar study of nephrolithotomy, pyelolithotomy and ureterolithotomy. Anatomical factors are important in stone formation, and partial nephrectomy is of value in the management of renal stones.

The Effect of Allopurinol on Urinary Oxalate Excretion in Stone Formers

“…When dealing with a metabolic stone or where there is an accompanying renal abnormality such as renal tubular acidosis (Williams and Chisholm, 1976) it can be expected that the recurrence rate will be higher than when dealing with a phosphatic type of stone, provided that infection can be eliminated (Sleight and Wickham, 1977). What is certain is that with the passage of time a recurrence of stones becomes more likely and may even reach as high as 34% 20 years after the initial stone presentation (Rose and Follows, 1977).…”

Guidelines on Urolithiasis<footref rid="foot01">¹</footref>

“…Lower calix fragments are more commonly seen when there is an acute (<90°) infundibulopelvic angle [29]. A lower pole resection is an alternative that should be considered in case of residual fragments and no functioning parenchyma [30]. Percutaneous chemolysis is an alternative treatment for stone fragments composed of magnesium ammonium phosphate, carbonate apatite, uric acid, cystine and brushite.…”

Partial Nephrectomy: An Option in Calculus Disease?

“…Rose and Follows, 1977). Swinney, 1966;Myrfold and Fritjofsson, 1971 ; Lower pole partial nephrectomy and nephrolithotomy Rose and Follows, 1977). This may be due either to Lower pole partial nephrectomy and pyeloplasty the complexity of our patients (40% had partial Lower pole partial nephrectomy and nephrolithotomy nephrectomy carried out with some other procedure) or to a lack of the intra-operative radiography 14 2 with drainage that Stewart (1960) insisted was an integral part of partial nephrectomy.…”

“…Subsequent studies have shown an incidence of residual calculus and significant stone recurrence from this precedure, although the latter appears significantly less in the ipsilateral kidney than that seen following simple stone removal ? Rose and Follows, 1977). Swinney, 1966;Myrfold and Fritjofsson, 1971 ; Lower pole partial nephrectomy and nephrolithotomy Rose and Follows, 1977).…”

“…These results compare unfavourably with the incidence of complications and subsequent morbidity from both PCNL and ESWL (Segura et al, 1985;Das et al, 1987;Lingeman et al, 1987;Payne and Webb, 1988). PN is also an ablative procedure, approximately 20% of the renal mass being removed by polar resection (Rose and Follows, 1977), whilst the overall nephron loss has not been determined. In contrast to this, it has been shown that there are no long-term anatomical consequences of PCNL as determined by CT scanning (Marberger et al, 1985) and no appreciable nephron loss from radioisotope and morphological studies (Marberger et al, 1985;Webb and Fitzpatrick, 1985).…”