Outcome of Single Tract Percutaneous Nephrolithotomy in Patients Presenting with Staghorn Calculus at Tertiary Care Hospital, Islamabad

Abstract

Background: Percutaneous nephrolithotomy (PCNL) is one of the most effective and less invasive surgeries for treating renal calculi, especially staghorn calculi. Several factors determine early success rates of PCNL, including stone size, composition, and location, specific to the patient, comorbid conditions, and body habitus. Objectives: The purpose of this study was to determine the efficacy of single tract percutaneous nephrolithotomy (PCNL) specifically assessing complications, transfusion requirement and stone free rate in staghorn renal calculi in a tertiary care hospital in Islamabad. Methods: This study was a prospective descriptive cross-sectional study which was carried for six months in the KRL Hospital in Islamabad after approval from ERB (KRL-HI-PUB-ERC/Dec23/01). Among the 194 patients, 100 were male and 94 were female. Thus, information regarding the patients’ characteristics and the operation features as well as the profiles and details of the complications during the peri-operative period were documented. Stone clearance below medical management was considered as fragments of ≤ 0.4 cm. Results: A stone-free rate of 66.5% was established and females' treatment was more effective, showing 78.7%, while males had only 55%. Regarding transfusions, 27·8% of patients required a transfusion. Both obesity and longer operation duration affected the stone clearance rates with a mixed trend. Side effects, including short-term fever and urinary incontinence, were rare and could easily be controlled. Conclusion: Single-tract PCNL is highly effective and safe in managing staghorn calculi and should continue to be advocated in developing countries with limited resources. Still, clearance rates are impressive, and complications are low.