Role of Surgical Intervention Versus Endoscopic PCNL For Partial and Complete Staghorn Calculi

Abstract

SUMMARY AND CONCLUSION stones represents a therapeutic challenge to urologists. Treatment options include ESWL monotherapy, PCNL, PCNL and ESWL, and open surgery. Open surgery can be used for giant staghorn stones in cases not expected to be removed by reasonable number of endoscopic procedures or in cases like (morbid obesity, skeletal deformities). In our thesis we studied both PCNL and open nephropyelolithotomy as management of staghorn stones. The overall stone free rate between the two modalities used in our study, percutaneous nephrolithotomy and open surgery, achieved were 80% and 90% respectively. In our study, Open nephropyelolithotomy had more incidence of intraoperative complication as organ injury,intraoperative hemorrhage and need of blood transfusion and higher incidence of pleural injury and more hospital stay period and cost than PCNL. Also postoperative complication such as postoperative fever and wound infection are more with open nephropyelolithotomy. But stone residual is slightly more in PCNL than open nephropyelolithotomy in treatment of staghorn stones. But we overcome this disadvantage by postoperative ESWL for patients underwent PCNL so we will achieve more stone free rate and prevent the complications of open surgery.