Standard-Tract Combined with Mini-Tract in Percutaneous Nephrolithotomy for Renal Staghorn Calculi

Purpose: To compare the safety and efficacy of standard-tract combined with mini-tract to single standard-tract in percutaneous nephrolithotomy (PCNL) for renal staghorn calculi. Methods: The records of 216 patients with staghorn calculi (110 (50.9%) had complete and 106 (49.1%) had partial) who received PCNL were reviewed retrospectively. 58 patients received standard-tract combined with mini-tract PCNL (group A) and 158 patients underwent single standard-tract PCNL (group B). Both groups had comparable demographic data. Operation time, stone-free rate, blood transfusion rate, hospital stay and complications were analyzed. Results: Postoperative Clavien score in the two groups was similar. The rate of blood transfusion and perioperative bleeding requiring superselective embolization were not statistically significant between the groups (p = 0.557, 0.463, respectively). The mean operation time was comparable between groups in the standard-tract combined with mini-tract group. The stone-free rate was significantly higher (89.7 vs. 78.5%, p = 0.044) in group A than in group B. The rate of second PCNL was higher in group B. Conclusion: The standard-tract combined with mini-tract results had higher success rates with no increase in the incidence of complications, and should be the first option for renal staghorn calculi. (c) 2014 S. Karger AG, Basel