RETROGRADE PERCUTANEOUS NEPHROLITHOTOMY USING THE LAWSON TECHNIQUE FOR MANAGEMENT OF COMPLEX NEPHROLITHIASIS

Percutaneous nephrolithotomy remains an important technique for managi ng complicated nephrolithiasis. Retrograde percutaneous nephrostomy cr eation has been promoted as an alternative to the standard antegrade t echnique, We reviewed our first 41 consecutive attempts utilizing the Lawson technique for managing patients with complicated nephrolithiasi s. Percutaneous access was achieved in 40 attempts (98%), Thirty-six ( 90%) of the retrograde nephrostomy tracts were adequate for lithotrips y or stone extraction during the same anesthetic, Twenty-three (56%) o f the kidneys treated with the Lawson procedure were rendered stone fr ee, Nine patients had minimal residual stone burden (fewer than five f ragments, 4 mm or smaller) by the time of discharge, A single Lawson p rocedure rendered 10 kidneys (24%) stone free, An additional 20 clinic procedures and 17 anesthetic procedures were performed on the 40 kidn eys, Complications were minimal, with three patients (8%) requiring tr ansfusion.