📃 Paper Title: The case for a more aggressive approach to staghorn stones
🧍 Author: Blandy and Singh
🕒 Year: 1976
📚 Journal: The journal of urology
🌎 Country: U.K.
ㅤContext to the study:
What is a landmark paper in the management of staghorn stones?
ㅤ✅ Take-home message of study:
Conservatively managed stones carry a mortality risk.
Follow-up in conservative and operative group were not matched.
The mortality rates are not applicable to modern mortality rates
The conservatively managed group is not representative of the modern cohort of incidentally detected staghorn stones (20% had solitary kidneys, all has pain and infection)
ㅤ Retrospective cohort study
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Study participants:
60 cases managed conservatively
125 cases managed with operative removal (extended open pyelolithotomy)
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Key study outcomes:
28% mortality rate for conservative management
7.2% mortality rate in operative management
All patients had pain and infection
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Study Limitations:
Study population comprises of those with pain and infection (as apposed to including incidentally detected staghorn stones)
High mortality rate of operative management not representative of modern rates
Up to 20 years of follow-up
Mortality rate in conservative group included patient deaths from RCC and unknown causes.
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