Staghorn calculi: percutaneous extraction versus anatrophic nephrolithotomy

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Staghorn stones pose significant treatment challenges.
• Traditional open surgery for staghorn stones involves prolonged recovery and potential complications.

Purpose of the Study:

• To compare percutaneous ultrasonic lithotripsy (PUL) with anatrophic nephrolithotomy (AN) for staghorn stones.
• To evaluate procedure time, success rates, complications, and recovery.

Main Methods:

• Retrospective comparison of 75 patients undergoing PUL and 25 patients undergoing AN.
• Data collected on procedure duration, stone fragment retention, blood transfusion requirements, narcotic use, and return to work.

Main Results:

• PUL had a shorter procedure time (155.1 vs. 266.5 minutes) and faster return to work (14.3 vs. 54.5 days post-discharge).
• PUL required fewer blood transfusions (53% vs. 70%) and less narcotic use (16 vs. 33 doses).
• Higher retained stone fragment rate in PUL (13.3% vs. 0%).

Conclusions:

• Percutaneous ultrasonic lithotripsy is favored over open stone removal for staghorn stones due to shorter procedure times and faster recovery.
• While stone fragment retention is higher with PUL, the overall benefits in terms of patient recovery and resource use are significant.