Is single tract puncture feasible in percutaneous nephrolithotomy for staghorn calculus: our experience from a tertiary care centre

Introduction: Staghorn calculi are branching stones that usually fill the renal pelvis and branch into a few or all the calices. However, complex caliceal and staghorn stones are difficult to remove with a single-tract PCNL approach. A trend toward the use of percutaneous monotherapy using multiple tracts as the preferred treatment option for most staghorn or complex calculi has emerged. Methods: The single center observational study was carried out on 51 adult patients having staghorn stone from January 2020 to June 2022 at KMC Manipal. Imaging was done to assess the size of the stones, the anatomical features of the kidney and its function, and to accurately plan the operative approach. PCNL was performed in the prone-position; Postoperatively, patients were monitored determining the efficacy of PCNL, perioperative blood loss, the duration of the operative procedure and hospital stay, and the resulting complications. Results: 42 Single tracts (82.35%), 09 Multiple tracts (17.64%) PCNL was performed. Stone burden=complete staghorn, 33 (64.70%), Partial staghorn 18 (35.30%). Mean age was 48.65 years. Mean length of stones, 25.28 mm. Number of stone, Single-31 (60.78%), Multiple-20 (39.22%). Mean procedure time 117.28±9.12. 9 patients had bleeding requiring blood transfusion and one patient requiring angioembolization. Conclusion: PCNL is effective and safe in management of staghorn renal stones.