Evaluation of open surgery for staghorn calculi in children.

We evaluated the results of open surgery in 19 children with staghorn calculi. The median age was 3.5 years (range 10 months to 14 years). One patient had bilateral calculi, hence 20 renal units were operated upon. Stone clearance was achieved in 19 cases by means of a Gil-Vernet pyelocalycolithotomy, alone (n = 10) or in combination with limited radial nephrotomies (n = 9). Extended nephrolithotomy was performed in only 1 case. Complete stone clearance was achieved in 13 kidneys (65%). Long-term follow-up showed that there was no stone recurrence in any of the 13 renal units rendered completely stone free at surgery. There was symptomatic stone recurrence in 1 of the remaining 7 renal units with small residual fragments left behind, while in 2 others the residual fragments were voided spontaneously. Preoperative and postoperative assessment with 99mTc-DMSA renal scans confirmed that no functional loss resulted in any of the operated kidneys. Open surgery proved to be safe and effective in the treatment of staghorn calculi in children.