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 stones using 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.
Key words: PNCL, struvite, staghorn, urinary tract calculus.
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