Abstract
Objective: To compare the efficacy of percutaneous
nephrolithotomy (PCNL) with open surgery for the
treatment of renal staghorn stones in our setting.
Methodology: This prospective interventional study
was conducted at AIMS, Hyderabad, from January to
October 2019. We included 70 patients presenting with
complete staghorn stonesusing non-probability
consecutive sampling technique. Stone clearance rate,
postoperative complication rate, mean operative time,
hospitalization days and culture on follow-up were
compared for both methods.
Results: Mean age of patients was 44.8 ± 8.7 years
(range 24 – 63). PCNL provided an overall stone
clearance rate of 80%; 84% for partial staghorn stones
while 70% for complete staghorn stones. In open
surgery group, an overall stone clearance rate was
85.7%; 94% for partial staghorn stones and 77% for
complete staghorn stones. Postoperatively, out of the
35 patients who underwent PCNL, 1 (2.9%) had a
wound infection, 6 (17.1%) had leakage and 1 (2.9%)
experienced uropathy. Amongst the patients who
underwent open surgery, 2 (5.7%) had wound
infection, and 2 (5.7%) had leakage (p = 0.307).
Conclusion: PCNL was a very effective treatment
modality for both partial and complete branching
staghorn stones in our setting. The stone clearance rate
for PCNL was as high as that of open surgery with low
mean operative time, reduced hospitalization days, and
a better overall outcome.
Keywords: PCNL, struvite, staghorn, urinary tract
calculus.
