156 C K C K C K C K PERCUTANEOUS NEPHROLITHOTOMY: A MINIMAL INVASIVE SURGICAL OPTION FOR THE TREATMENT ............... KMUJ 2012; Vol. 4, No. 4: 156-160 PERCUTANEOUS NEPHROLITHOTOMY: A MINIMAL INVASIVE SURGICAL OPTION FOR THE TREATMENT OF STAGHORN RENAL CALCULI Anayat Ullah 1 , Muhammad Kamran Khan 1 , Ata Ur Rahman 2 , Riaz Ur Rehman 1 ABSTRACT Objectives: To see the safety and efficacy of percutaneous nephrolithotomy (PCNL) for the treatment of staghorn renal stone. Methodology: This descriptive study was conducted in Department of Urology and Renal Transplantation, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar, Pakistan from June 2010 to May 2012. A total of 52 patients who underwent PCNL for staghorn renal stones irrespective of the age and gender were selected for this study through the technique of non-probability consecutive sampling. All the procedures were carried out by a single surgeon, under general anesthesia and in prone position. Data was analyzed on a computer using SPSS version 10 for windows XP. Results: Mean age was 35.9±14.5 years (range 7-59 yrs). The average procedure time was 105±19.3 minutes (range 75–180 minutes). The mean size of the stone was 3.9±1.2 cm (range 3.1-5.8 cm). In 41 of 52 (78.84%) patients, complete stone clearance was achieved after a single session of PCNL. The procedure was staged in 04 (7.7%) patients and a repeat PCNL was performed. Complete clearance (including second stage PCNL) was achieved in 44 of 52 (84.61%) patients. With dual therapy (PCNL + shock wave lithotripsy), stone clearance was achieved in 48 of 52 (92.3%) patients. The commonest complication encountered was bleeding in 4/52 (7.7%) patients necessitating blood transfusion. The mean hospital stay was 3±0.9 days and nephrostomy tube was kept for 2 days. Conclusion: PCNL is safe and effective treatment for staghorn renal calculi associated with less morbidity and shorter hospital stay. Key Words: Staghorn stone, Percutaneous Nephrolithotomy (PCNL), Efficacy. This article may be cited as: Ullah A, Khan MK, Rahman AU, Rehman RU. Percutaneous nephrolithotomy: A minimal invasive surgical option for the treatment of staghorn renal calculi. Khyber Med Univ J 2012; 4(4): 156-160. 1: Postgraduate Resident Urology and Renal Transplant Unit, Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, Pakistan 2: Professor, Urology and Renal Transplant Unit, Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, Pakistan Address for Correspondence Dr Anayat Ullah c/o Alnoor Drug Agency, Small Industrial Estate, Kohat Road Peshawar Pakistan - 25000 E-mail: dawar_kemc@hotmail.com Cell No: 03335552441 Date Submitted: October 15, 2012 Date Revised: December 18, 2012 Date Accepted: December 20, 2012 INTRODUCTION Urolithiasis is a major public health problem and is the commonest urologic disease in Pakistan. The estimat- ed prevalence in the country is 10-15% in the population but only 1-2% symptomatic patients come to the tertiary care hospitals for treatment. 1 The term staghorn calculi refer to branched stones that occupy the renal pelvis and contain one or more calyceal extensions. 2 The risk of ob- structive nephropathy leading to chronic renal failure and life-threatening urosepsis are well-known complications of staghorn stones. 3 If left untreated the mortality rate at 10 years is estimated to be 28% due to complications of staghorn calculi. 4 The goal of stone treatment is to use less morbid, minimal invasive and effective modality. 5 The surgical management of urinary calculus has evolved considerably over the past few decades especially with the introduction of minimal invasive procedures and shock wave lithotrip- sy (SWL) and percutaneous nephrolithotomy (PCNL). 6 The practice of PCNL, having been refned over time, continues to evolve and has largely replaced open stone surgery for the treatment of staghorn renal stones. This has been complemented by advances in technology and equipment resulting in stone removal with less morbidity, shorter convalescence, and reduced cost compared with open surgery. 7 The purpose of this study was to evaluate the out- come and complications in patients who were undergoing Percutaneous Nephrolithotomy for staghorn renal calculi at a single, tertiary referral stone center. METHODOLOGY Between June 2010 and May 2012, all patients who underwent PCNL for staghorn stones at the Institute of ORIGINAL ARTICLE