Extracorporeal renal surgery and autotransplantation for complicated stone disease1

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Most patients with extensive renal calculous disease can be managed satisfactorily by percutaneous or in situ surgical techniques. However, in selected patients with advanced nephrolithiasis in whom prior surgical therapy has failed, extracorporeal renal lithotomy and/or autotransplantation may provide the best method of achieving complete stone removal and unobstructed urinary drainage from the upper urinary tract. The most common indications for this approach are recurrent nephrolithiasis with stenosis of the renal pelvis or ureter, recurrent renal colic, and extensive ureteral loss following prior operative therapy. In all cases, close postoperative follow-up, with prevention of infection and treatment of metabolic disorders, is integral to successful long-term management.



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