OUTCOME OF OF PERCUTANEOUS NEPHROLITHOTOMY IN STAGHORN CALCULI

Objective: To detrmine the outcome of percutaneous nephrolithotomy in the management of staghorn type calculi in
adult patients.
Study Design: This is a descriptive study.
Duration: This study was carried out from October 2007 to April 2011.
Patients and Methods: This study was conducted at Shaikh Zayed Hospital, Lahore and included 100 cases of
staghorn type calculi undergone PCNL. Those patients in whom PCNL was planned preoperatively but abandoned
because of problem in access or incidental finding of any associated urinary tract anomaly requiring prior attention
or an open approach were excluded from the study. Procedure (PCNL) was done under general anesthesia with
patient in modified lithotomy position for retrograde insertion of ureteric catheter and to do pyelography during the
procedure, than patient’s position was changed to prone or prone oblique position for percutaneous renal stone
fragmentation. Tract was made by the urologist, C-arm fluoroscope was used for imaging and access.
Results: In our study, their were 100 renal units. Out of these, 73 were males and 27 females. The mean age was
41.3±14.24 years. We dealt with a mean stone burden of 5.1±1.9cm, the size ranged from 3.3cm to 11.8cm. The
overall stone clearance with PCNL only was 71% whereas it increased to 91% when combined with ESWL as dual
therapy for residual stones. The mean length of hospital stay was 4.4 days. The overall complication rate was 9%.
Conclusion: Percutaneous nephrolithotomy is safe and effective procedure in staghorn type stones. Combining
PCNL with ESWL for residual stones can remarkably increase stone clearance.
Key Words: Percutaneous Nephrolithotomy, Staghorn Type Calculi.