Late Results of Partial Nephrectomy for Renal Lithiasis

Abstract

Partial nephrectomy was performed for renal Uthiasis in 65 patients who have been followed up for 5 to 18 years postopsratively. Transient postoperative complications occurred in 16 patients and loss of function in the residual ipsilateral kidney in 5 patients. Stone recurred in 37 patients, ipsilaterally in 28. The frequency of recurrence was similar in patients with and without urinary infection. Histologic study of the resected tissue showed signs of chronic pyelonephritis in 48 of 64 patients, 31 of whom had no clinical signs of infection. During the follow-up period urinary infection occurred in 32 patients. It was more severe and more frequent when infection had occurred also preoperatively (20: 32) than in patients without preoperative infection (12: 32). Careful preoperative investigation, prevention or counteraction of infection and atraumatic surgical technique are important for a good result. The length of the follow-up period must be taken into consideration when the frequency of stone recurrence is evaluated. Partial nephrectomy should be reserved for strictly selected cases and eradication of lithiasis is to be expected only when the pathologic process is localized.