Abstract
Objective: Identifying factors that influence stone-free rates (SFRs) and complications in patients who have staghorn stones and have undergone percutaneous nephrolithotomy (PCNL)
Patients and methods: A retrospective case control study of individuals who had PCNL for staghorn stones, between January 2017 and January 2021 were used to create a database. The study comprised 206 individuals (99 men and 107 women) who had an average (SD) age of 44.80±12.08 years and had staghorn stones in the renal pelvis that had branched into more than one major calyces and borderline staghorn stones(renal pelvic stone that had branched into only one major calyx). An expert endourologist conducted or supervised the PCNL. Every perioperative complication has been documented. Following PCNL, the condition of stone-free has been assessed.
Results: The SFRs following the initial PCNL procedure were successful in 137 patients (66.5%). Twenty-three patients (11.2%) needed a 2nd look at PCNL. The total SFR following the 2nd look PCNL was 73.3%. The most intraoperative complication was hemorrhage (8.7%), followed by pelvic perforation (3.4%). Colon injury was reported in (1.5%) of the cases. Postoperative complications were reported in 25 cases. Fever (5.3%), followed by persistent urine leakage (3.9%).The multivariate analysis revealed that ischemic heart disease (p=0.033), stone diameter >4.5 cm (p < 0.001), stone density >900 HU (p=0.005), and complete staghorn stone (p=0.002) were the
independent factors inversely affect the stone-free status.
Conclusion: Ischemic heart disease, stone diameter, stone density, and complete staghorn stone were the independent factors affect the stone-free status.