Evaluation of stone volume and its relationship with surgical outcomes in patients with staghorn calculi.

Abstract

Introduction:Urolithiasis is one of the most common renal diseases with a significant burden on health-care system worldwide. Here, we evaluated the stone volume and its relationship with duration of operation, blood loss, and total stone clearance in patients with staghorn calculi.Materials and Methods:This was a prospective, single-center study conducted from October 2015 to September 2017. Patients of either sex aged more than 18 years of age with a confirmed diagnosis of staghorn calculus were eligible to participate in the study. Eligible patients were divided into three groups based on stone volume (assessed by three-dimensional computed tomography): Group 1 (≤5000 mm3), Group 2 (>5000 to ≤20,000 mm3), and Group 3 (>20,000 mm3).Results:A total of 85 patients were enrolled in the study (Group 1, n = 9; Group 2, n = 66; and Group 3, n = 10). The mean age was 43.68 years, and 62.4% of patients were male. The mean operative time increased significantly from Groups 1–3, (31.67, 60.14, and 92.30 min, respectively). The mean pre- and postoperative hematocrit was highest in Group 3 (2.82%) (P < 0.0001). Overall, the correlation between stone volume and operative time and difference in hematocrit showed a positive relationship. A total of five patients had residual calculus, and only four patients reported complications.Conclusions:The results showed that patients with larger stone volume need more operative time and may have more blood loss.