Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
Curr Opin Urol. 2012 Mar;22(2):148-53. doi: 10.1097/MOU.0b013e32834fc306.
The term staghorn is plagued by an unclear morphology There is a need for clinical definition of staghorn that could classify patients in either of the two ends of the treatment spectrum for percutaneous nephrolithotomy (PCNL) monotherapy.
Staghorn morphometry was identified as a prognostic tool to predict tract(s) and stage(s) for PCNL monotherapy for staghorn. Staghorn morphometry requires a three-dimensional computed tomography urography assessment by volume rendering software. As per the detailed stone morphometric analysis, a clinically important definition of staghorn calculi based on the high odds probability of multiple tract(s) and stage(s) is proposed. Type 1 staghorn has a total stone volume of less than 5000 mm with less than 5% unfavorable calyx stone percentile volume, whereas type 3 staghorn has a total stone volume of more than 20,000 mm with greater than 10% unfavorable calyx stone percentile volume. Type 2 staghorn is in-between type 1 and 2. Based on the prediction model for achieving clearance by PCNL monotherapy, type 1 staghorn would require single tract and stage, type 2 single tract-single/multiple stages or multiple tract-single stage and type 3 multiple tract and stage.
Staghorn morphometry based clinical classification of staghorn is an exciting concept for PCNL monotherapy. Further prospective studies are required to validate the staghorn morphometry based clinical variate of staghorns. The prospective studies should take into account clinical presentations, operative complications, tract and stage required, postoperative complications, hospital stay, operative cost and stone-free status.
鹿角石一词的形态学定义不明确，需要对其进行临床定义，以便将患者分为经皮肾镜碎石术（PCNL）单一疗法的治疗谱两端。
鹿角形态计量学被确定为预测 PCNL 单一疗法治疗鹿角结石的通道和阶段的预后工具。鹿角形态计量学需要通过体绘制软件对三维 CT 尿路造影进行评估。根据详细的结石形态计量分析，提出了一种基于多通道和多阶段高可能性的临床重要鹿角结石定义。1 型鹿角结石的总结石体积小于 5000mm，不利肾盏结石百分比体积小于 5%，而 3 型鹿角结石的总结石体积大于 20000mm，不利肾盏结石百分比体积大于 10%。2 型鹿角结石则介于 1 型和 3 型之间。根据 PCNL 单一疗法实现清除的预测模型，1 型鹿角结石需要单通道和单阶段，2 型需要单通道-单/多阶段或多通道-单阶段，3 型需要多通道和多阶段。
基于鹿角形态计量学的鹿角临床分类是 PCNL 单一疗法的一个令人兴奋的概念。需要进一步的前瞻性研究来验证基于鹿角形态计量学的鹿角临床变量。前瞻性研究应考虑临床表现、手术并发症、所需通道和阶段、术后并发症、住院时间、手术费用和无结石状态。
