title: Percutaneous-based management of Staghorn calculi in solitary kidney: combined mini percutaneous nephrolithotomy versus retrograde intrarenal surgery.
abstract: BACKGROUND
  Mini percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are well-established techniques with little morbidity. The combined use of standard PCNL and the mini-PCNL or the RIRS technique was evaluated and compared to investigate their own role in the management of staghorn calculi in solitary kidney.
  
  
  METHODS
  23 patients received combined standard PCNL and mini-PCNL (group 1), and 22 patients received combined standard PCNL and RIRS (group 2). The treatment results and complications were evaluated and compared.
  
  
  RESULTS
  The mean operation time was 128.8 ± 9.1 min in group 1 and 109.8 ± 10.7 min in group 2 (p < 0.001). The decrease in hemoglobin level in group 1 was significantly higher than that in group 2 (3.5 ± 0.6 vs. 2.1 ± 0.5 g/dl, p < 0.001). The final stone-free rate was significantly higher (p = 0.038) in group 2 (90.9%) than in group 1 (65.2%).
  
  
  CONCLUSIONS
  Combined standard PCNL and RIRS technique can extract the majority of staghorn calculi quickly by PCNL with EMS Lithoclast, and RIRS used simultaneously can reduce the need for multiple tracts and therefore reduce blood loss and potential morbidity related to multiple tracts, shorten the operation time and achieve a high stone-free rate.
authors.affiliation: Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhong
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Zhao
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Sunil
authors.initials: S
authors.lastname: Swami
authors.forename: Guohua
authors.initials: G
authors.lastname: Zeng
mesh_terms: D016063:Blood Loss, Surgical; D002681:China; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*