PERCUTANEOUS NEPHROLITHOTOMY: A MINIMAL INVASIVE SURGICAL OPTION FOR THE TREATMENT OF STAGHORN RENAL CALCULI

Objectives: To see the safety and efficacy of percutaneous nephrolithotomy (PCNL) for the treatment of staghorn renal stone.Methodology: This descriptive study was conducted in Department of Urology and Renal Transplantation, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar, Pakistan from June 2010 to May 2012. A total of 52 patients who underwent PCNL for staghorn renal stones irrespective of the age and gender were selected for this study through the technique of non-probability consecutive sampling. All the procedures were carried out by a single surgeon, under general anesthesia and in prone position. Data was analyzed on a computer using SPSS version 10 for windows XP.Results: Mean age was 35.9±14.5 years (range 7-59 yrs). The average procedure time was 105±19.3 minutes (range 75–180 minutes). The mean size of the stone was 3.9±1.2 cm (range 3.1-5.8 cm). In 41 of 52 (78.84%) patients, complete stone clearance was achieved after a single session of PCNL. The procedure was staged in 04 (7.7%) patients and a repeat PCNL was performed. Complete clearance (including second stage PCNL) was achieved in 44 of 52 (84.61%)patients. With dual therapy (PCNL + shock wave lithotripsy), stone clearance was achieved in 48 of 52 (92.3%) patients.The commonest complication encountered was bleeding in 4/52 (7.7%) patients necessitating blood transfusion. The mean hospital stay was 3±0.9 days and nephrostomy tube was kept for 2 days.Conclusion: PCNL is safe and effective treatment for staghorn renal calculi associated with less morbidity and shorter hospital stay.