Combined Single-Tract of Minimally Percutaneous Nephrolithotomy and Flexible Ureteroscopy for Staghorn Calculi in Oblique Supine Lithotomy Position.

Abstract

To present our experience of combined single-percutaneous tract minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in managing staghorn calculi (SC) in oblique supine lithotomy position and to define the safety, efficiency, and feasibility of this approach. Eighty-seven patients with SC treated with surgery in our hospital from March 2014 to January 2016 were retrospectively analyzed. The 87 patients were divided into 2 groups according to operative type: MPCNL combined with FURL (Group 1, n = 44) and MPCNL (Group 2, n = 43). The clinical data, perioperative parameters, and postoperative complications of the 2 groups were compared and analyzed. There were no significant differences in age, gender, stone type, and size ( P = .873, .570, .448, and .593, respectively). The average operative time, the average hospitalization time after surgery, the hemoglobin level, and the complication rate of Group 1 were lower than that of Group 2 ( P < .05 each). The first and second time stone free rates of Group 1 were higher than that of Group 2 ( P < .05 each). Single-tract MPCNL combined with FURL in the oblique supine lithotomy position to treat SC could improve stone free rates, reduce operative time and length of hospital stay, decrease renal hemorrhage, and avoid other complications. We think this is an efficient and safe operative approach to manage SC.