Prospective Study Of 200 Cases Of Staghorn Calculus- A Single Centre Experience.

ABSTRACT

Background: Staghorn stones are large branching stones that fill the renal pelvis and renal calyces and they can be complete or partial depending on the occupancy of the collecting system. . PCNL is a demanding procedure mainly for staghorn stones and may require multilple percutaneous tracts or multilple sessions of PCNL for complete clearance of stones. Hence ; we planned the present study to analyse patients undergoing PCNL for staghorn calculi. Material and Methods: In present study 200 patients underwent PCNL for the treatment of staghorn kidney stones. After exclusion criteria patients were selected and underwent standard PCNL. Preoperative , Intraoperative and Postoperative data was collected. Results: Out of 200 patients 95 (47.5%) were males and 105 (52.5%) patients were females. 120 patients (60%) were diagnosed with partial staghorn calculi whereas 80(40%) patients were diagnosed as complete staghorn Calculi. 37.5% patients were rendered stone free through single access port whereas 62.5% required multiple access port for PCNL in which 57.5% needed 2 access ports, 3% needed 3 access ports and only 2% needed 4 access ports for PCNL. 24 (12%) patients required 2nd stage procedure for residual stones and 1 (0.5%) patient become stone free after 3rd stage PCNL. Bleeding requiring blood transfusion was the most common complication in 21% patients. Whereas fever, hemothorax, hydrothorax, paralytic ileus were encountered in 12%,0.5%,0.5% and 4% patients respectively. Conclusion: For staghorn calculus PCNLis safe and effective procedure with acceptable morbidity and without mortality. Now PCNLhas almost replaced the open surgeries like pyelolithotomy , nephrolithotomy . with experience staghorn calculus can now be managed by minimum invasive technique like PCNL with no scar , no risk of incisional hernia , lesser hospital stay and minimum morbidity compared to open procedures