STUDY OF PERCUTANEOUS NEPHROLITHOTOMY (PCNL) FOR TREATING STAGHORN STONES, ITS OUTCOME, STONE CLEARANCE, INTRA-OPERATIVE, POST-OPERATIVE COMPLICATIONS

Abstract

Background: In the last two decades the treatment of staghorn stones has changed from traditional open surgery to minimally invasive methods such as percutaneous nephrolithotomy (PCNL) monotherapy and combination of PCNL and ESWL. Present study was aimed to assess the results of percutaneous nephrolithotomy (PCNL) for treating staghorn stones at a tertiary-care center. Material and Methods: Present study was singlecenter, prospective, observational study, conducted in patients > 18 yrs, either gender, cases of partial/ complete staghorn calculus in pelvic calycal system, underwent PCNL. Results: Out of 140 patients, majority were female patients (66%). Common symptoms noted in present study were burning micturition (72.1 %), hematuria (5.7 %), nocturia (5 %), increased frequency (3.6 %), weak stream (2.9 %), straining (2.1 %), incomplete emptying (2.1 %) & urgency (0.7 %). 54.28% patients had urine analysis positive for suggestive of pus cells. 44.1% had urine culture suggestive of growth. 93.6%, 5% and 1.4% patients required 1,2 and 3 are the total numbers of assess site respectively. Intra operatively, 1,2 & 3 calyces punctured in 82.1%, 15.7% and 2.1% patients respectively. 97.9% (137 out of 140) and 2.1% (3 out of 140) had been operated in rst and second stages respectively. In 98.6% patients no complication was reported. 1 patient required blood transfusion and one patient had pleural effusion 12.1% needed secondary look PCNL. 19.3% patients had post-operative fever. 89.3% patients had x-ray suggestive of stone free status and 10.7% had x ray suggestive of residual stones. Conclusion: PCNL is a safe and effective procedure for the management of staghorn renal stones, with outcomes similar to those reported for percutaneous management of smaller volume non-staghorn stones.