Prayagraj: A 40-year-old man battling renal failure and severe sepsis after developing large stones in both kidneys underwent a complex surgery at Swaroop Rani Nehru Hospital, where doctors removed 37 stones from his left kidney in a single procedure on Friday.The patient, Shatrughan of Rewa (Madhya Pradesh), had been suffering from kidney stones for nearly a year. His condition deteriorated over the past month after he developed persistent fever and breathing difficulty. By the time he reached the hospital, he was suffering from severe infection and kidney failure and required ICU admission, ventilator support and dialysis. His serum creatinine was 4.2 at the time of surgery.Doctors said the stones in both kidneys were unusually large, measuring between 4.5cm and 6 cm. The family said the patient had been taking homeopathic and Ayurvedic treatment in an attempt to dissolve the stones before his condition worsened.After stabilising the patient, the urology team decided to operate on the left kidney first. On Friday, doctors performed an anatrophic pyelolithotomy at PMSSY Urology Operation Theatre. In the procedure, the kidney was carefully opened to access and remove the stones one by one. A total of 37 stones were removed, following which the kidney was repaired and a 5/26 double-J (DJ) stent was placed. The renal artery was clamped for around 20 minutes during the surgery.Urology department head Prof Dilip Chaurasia led the surgical team, assisted by Dr Shirish Mishra and Dr Gajendra. The anaesthesia team comprised Dr Dharmendra Yadav, Dr Pragati Saxena, Dr Archi Singh, Dr Kamal and Dr Shivmohan.Prof Chaurasia said the surgery was challenging because the patient had arrived with sepsis and kidney failure and had required both ventilator support and dialysis.“Once his condition improved, we decided to operate on the left kidney first. All 37 stones were removed and the kidney was repaired,” he said.Anatrophic pyelolithotomy is a complex surgical technique used selectively to remove very large or multiple kidney stones by carefully opening the kidney, extracting the stones and then repairing the organ, explaine Dr Chaurasia.The patient is currently under close observation, while doctors will assess the condition of his other kidney before deciding the next course of treatment.
