Case Report and Review of Literature on Anaesthetic Management for Open Anatropic Nephrolithotomy in a Case of Horseshoe Kidney with Bilateral Staghorn Calculi

Horseshoe kidneys are usually associated with a number of complications like PUJ obstruction, recurrent infections, recurrent stone formation, carcinoma and greater propensity to get traumatized. We report a case of 45yr old female with b/l large staghorn calculi with horseshoe kidneys. Anatrophic nephrolithotomy was performed under epidural and general anesthesia with anaesthetic challenges of massive blood loss, hypothermia, prolonged surgery, acidosis and postoperative analgesia. Anatrophic nephrolithotomy is a procedure in which parenchymal incision is made in an intersegmental plane allowing removal of large renal calculi. ANL has excellent stonefree rates but morbidity related to intraoperative and postoperative complications is a matter of concern.