Materials and Methods:
This retrospective study was conducted between April 2012 and January
2017 with patients who had undergone PCNL for staghorn stones. Patients
with a skeletal deformity, congenital kidney anomalies, coagulopathy,
and solitary kidneys, cases requiring multiple accesses, and patients
without staghorn stones were excluded from the study. A total of 182
staghorn stones were divided into two groups according to patient age:
those aged <65 years old were defined as Group-1 and those
aged ≥65 years as Group-2. The demographic, perioperative and
postoperative data were compared between these two groups.
All the patients were evaluated preoperatively using standard
non-contrast abdominal computed tomography (CT). The patients’
demographic and preoperative characteristics, including operation side
and history, stone burden, gender, metabolic syndrome, and stone density
were recorded. In addition, intraoperative and postoperative results
(operation and fluoroscopy time, nephroscopy time, calyx accessed,
complications, and stone-free status) were examined. Postoperative
complications were evaluated according to the Clavien scoring system
(8).
After the urine culture of the patients was confirmed to be negative,
they were taken to the operation room.
Stone burden was calculated in square millimeters in all patients
(length x width x π x 0.25, where 3.14 was taken as the mathematical
constant) (9). For staghorn stones, this calculation was performed
separately for each calyceal stone and the sum of all values was
accepted as the result. All PCNL operations were performed by
experienced urologists. Success was considered as complete stoneless or
detection of <4 mm stones on control CT performed at the first
postoperative month.