The Comparison of Two Versus More Than Two Tracts Percutaneous Nephrolithotomy for the Management of Staghorn Calculi
Journal Title: Bagcilar Medical Bulletin - Year 2021, Vol 6, Issue 1
Abstract
Objective: In this study, we evaluated the outcomes of two tracts and more than two tracts for percutaneous nephrolithotomy (PCNL) performed in patients with staghorn calculus. Method: We performed multi-tract PCNL on 132 patients with staghorn calculi, whose stone burdens varied between 7 and 28.2 cm2 in our clinics between March 2015 and August 2019. We compared the outcomes and complications of multi-tract PCNL in two groups of patients. Group 1 included patients with two percutaneous tracts, while the patients in group 2 had more than two percutaneous tracts. Stone surface areas and locations were preoperatively recorded. Intraoperative data included number of tracts, blood transfusion rates and operative times. Postoperative stone-free rates (SFR) were also investigated. Results: Group 1 included 93 patients, while group 2 included 39. The mean stone burden (MBS) was 10.4 cm2 in group 1 and 11.3 cm2 in group 2, with no statistical difference. Blood transfusion rates were 22.5% (21/93) in group 1 and 46.1% (18/39) in group 2 (p<0.05). The mean operative times were 135 min in group 1 and 168 min in group 2. SFR were 74.1% (69/93) and 74.3% (29/39), respectively, and there was no significant difference (p=0.93). Major complications were recorded in 4 patients (3.4%). In group 2, two patients had undergone angioembolization due to A-V fistula, and intubated thoracostomy was performed on 1 patient due to the development of hydropneumothorax. Conclusion: Our study has demonstrated that performing more than 2 tracts for complete clearance of stones does not significantly increase SFR. In addition, increasing number of tracts is associated with higher blood transfusion rates, prolonged operative times and enhanced complication rates.
Authors and Affiliations
Yusuf Turushan Özcanlı, Mustafa Erkoç
Keywords
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- EP ID EP693321
- DOI 10.4274/BMB.galenos.2020.09.058
- Views 92
- Downloads 0
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