Number of tracts or stone size: which influences outcome of percutaneous nephrolithotomy for staghorn renal stones?.

Background: Percutaneous nephrolithotomy (PCNL) is the recommended first-line treatment for staghorn stones. To achieve complete stone clearance, PCNL may require using multiple tracts.

Objective: To evaluate outcome of PCNL in patients with staghorn calculi and its correlation with the number of tracts and stone features.

Methods: One hundred consecutive patients with staghorn renal stone who underwent PCNL were included in the study. Perioperative and postoperative features were recorded. Correlation of the variables with number of tracts and stone size was assessed.

Results: Mean age (± SD) was 49.6 ± 14.7 years. Our patients were ASA class I. The mean cumulative stone burden was 365.9 ± 156.5 mm(2). The mean number of tracts was 2.4 (range: 1-7), and stone-free rate was 83%. The stone-free rate (p = 0.026) and hospital stay (p = 0.005) correlated with stone size, but not with number of tracts. Postoperative fever correlated with stone size (p = 0.017) and number of tracts (p = 0.037).

Conclusions: PCNL using multiple tracts seem to be effective and safe in treatment of staghorn calculi. Most outcome measures correlated with stone size rather than number of tracts.