AUTHOR=He Xiaolong , Huang Xin , Zhai Qiliang , Song Leming , Deng Xiaolin 

TITLE=Retrograde intrarenal surgery with intelligent control of renal pelvic pressure for staghorn calculi: a case report

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1321184

DOI=10.3389/fmed.2024.1321184

ISSN=2296-858X

ABSTRACT=Percutaneous nephrolithotomy is the gold standard treatment for staghorn calculi. However, this study reviews a case of an almost complete removal of staghorn calculi following one session of retrograde intrarenal surgery with intelligent control of renal pelvic pressure(RIRS-ICP). A 45-year-old female patient with an 8.3×4.5 cm complete staghorn stone was infected with Proteus mirabilis.Two sensitive antibiotics, piperacillin tazobactam and etimicin, were administered for 3 days. Semirigid 7/8.4 Fr ureteroscope was used to treat the renal pelvis and upper calyceal calculi for 57 min. A 550-µm holmium laser fiber with 2.0 J×30 Hz was set.Next, a disposable flexible ureteroscope of 8.4 Fr was used to address residual middle and lower calyx stones for 94 min. A 200 µm holmium laser fiber with 1.0 J×30 Hz was set. The renal pelvis pressure was controlled within 15 mmHg. A 2 mm CT scan on the first postoperative day showed inferior caliceal residue of approximately 1.0×0.6 cm. No complications occurred. This suggests that RIRS-ICP is a safe and effective treatment for staghorn calculi.