S188: Percutaneous nephrolithotomy in treatment of Staghorn calculi

S188: Percutaneous nephrolithotomy in treatment of Staghorn calculi

S188: Percutaneous nephrolithotomy in treatment of Staghorn calculi Oner S.1, Ustun M.H.1, Aydos M.M.1, Kilic M.1, Avci S.2, Tuysuz V.2, Erdogan A.1, ...

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S188: Percutaneous nephrolithotomy in treatment of Staghorn calculi Oner S.1, Ustun M.H.1, Aydos M.M.1, Kilic M.1, Avci S.2, Tuysuz V.2, Erdogan A.1, Sambel M.1 1

Bursa Sevket Yilmaz Research & Education Hospital, Dept. of Urology, Bursa, Turkey, 2Bursa State Hospital, Dept. of Urology, Bursa, Turkey INTRODUCTION & OBJECTIVES: Percutaneous nephrolithotomy (PNL), combined methods (PNLESWL, PNL-PNL, PNL-ESWL-PNL) and open surgery are the choice of method in the treatment of staghorn calculi. In our study, the results of staghorn calculi treatment with PNL monotherapy were presented. MATERIAL & METHODS: Between November 2003 and October 2013, 212 patients (90 women, 122 men), had undergone PNL because of staghorn calculi. Mean age was 48,1 years (5 to 74). 180 patients (84,9%) were primary and 27 patients (%12,7) were secondary,4 patients (%1,8) were tertiary and 1 (% 0,4) patient was quarterner. In all cases 30 F amplatz dilation was performed. RESULTS: The average calculi area calculated by two dimensions was 2024 mm2 (80-9500 mm2). Mean anesthesia duration was 102,7 minutes (45-360) and average operation time was 73,9 minutes (15-300). For each case averagely 2,1 renal access (1-7) was required and averagely 15940 cc (range 1800-45000cc) saline was used. The stone free rate on discharge was 67,9% (144 patients). When residual fragments smaller than 4 mm were accepted as clinically insignificant, our success rate became %91,5 (194/212). 53 patients (25%) required blood transfusion. Any other major complication was not seen except embolisation requiring bleeding in two patients (%0,9),and hydrothorax treated conservatively in 4 patients. The mean postoperative stay was 3,7 days (1-25) and mean spent time with neprostomy was 2,88 days (1-12). CONCLUSIONS: PNL is a preferable choice of method in treatment of renal staghorn stones with acceptable success rate (91,5%). Blood transfusion rate is higher than non-staghorn stones but it is a minimally invasive treatment with shorter postoperative period. Eur Urol Suppl 2014; 13(7) e1526