, Compared with other treatments, such as open surgery, extracorporeal shock wave lithotripsy (ESWL), and combined surgery, PCNL has a lower morbidity rate and higher stone clearance rate. Percutaneous nephrolithotomy (PCNL), which is preferred for patients with staghorn stones, is a safe and successful technique. Therefore, complete removal and clearance rates are mostly considered when dealing with staghorn stones. Failure to eliminate staghorn calculus may destroy the parenchyma and kidney function and cause life-threatening sepsis. Staghorn calculi are branched stones that involve more than two calyces and occupy a large portion of the collection system. Single versus multiple mini-tract percutaneous nephrolithotomy for staghorn renal stone: A single-center study. How to cite this URL: Tsai IC, Chen ZH, Lee KH, Liu CL, Huang SK, Chiu AW. How to cite this article: Tsai IC, Chen ZH, Lee KH, Liu CL, Huang SK, Chiu AW. Keywords: Mini percutaneous nephrolithotomy, multiple tracts, staghorn stones Mini PCNL with multiple-tract access is a successful alternative to deal with staghorn stones involving multiple calyces. Conclusion: Multiple-tract access during PCNL is a safe and efficient method to manipulate staghorn kidney stones. Pseudoaneurysm attributed to Grade III complications occurred in one patient in Group 1. Clavien–Dindo Classification Grade II complications included urosepsis and blood transfusion, which occurred in five patients in Group 1 and three in Group 2. Mean changes in creatinine values were not statistically significant between the groups. Mean pre- and post-operative creatinine concentrations were 1.212 and 1.211 mg/dL in Group 1 and 1.206 and 1.157 mg/dL in Group 2. Complications included blood transfusion, resulting from a hemoglobin drop of 2.15 ± 0.96 and 1.59 ± 0.69 g/dL in Groups 1 and 2, respectively. The mean hospital stay was similar in both groups. Stone-free rates were 59% and 70.5% in Groups 1 and 2, respectively. The mean duration of fluoroscopy screening and operative time was longer in Group 2. Results: The mean number of percutaneous accesses in the multiple-tract group was 2.88, with most patients requiring two tracts. Both groups were compared in terms of perioperative findings and postoperative outcomes. Nineteen patients were managed by single-tract access (Group 1), and 17 patients underwent multiple-tract access (Group 2). Materials and Methods: Records of 36 patients with staghorn calculi who underwent PCNL at our institution between January 2018 and April 2020 were reviewed retrospectively. We reviewed our experience managing staghorn calculi with multiple tracts compared with a single tract. However, the creation of multiple tracts may have the potential risk of bleeding and higher complication rates compared with single-tract procedures. Purpose: Percutaneous nephrolithotomy (PCNL) is the standard procedure used for large kidney stones, and multiple tracts of PCNL are applied to achieve better stone clearance.
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