The experience of the Târgu Mureø Clinic of Urology in multimodal treatment of staghorn stones

Introduction: Percutaneous surgery is a safe and effective method in the treatment of staghorn stones. Objectives: the analysis of our experience in percutaneous treatment of staghorn stones. Over a period of 24 years (1987-2010), the percutaneous nephrolithotomy (PCNL), extracorporeal lithotripsy (ESWL), retrograde rigid ureteroscopy and antegrade rigid ureteroscopy have almost completely replaced open surgery. Materials and Methods: From a series of 7215 patients with urolithiasis, 1070 (14.83%) had staghorn stones (7 were children), and of these 17/ 1070 patients presented bilateral staghorn stones. Results: Average operating time was 115 minutes. The average duration of hospitalisation was 18.1 days. Stone free rate at the end of the intervention was 900/ 1070 (82.79%). We had postoperative complications in 142/1070 patients (13.06%), with 3/ 1070 (0.27%) deathscaused by haemorrhage (1) and toxico-septical shock (2). Conclusions: In order to a successful resolution of staghorn stones by minimally invasive methods it is necessary to have a good knowledge of three-dimensional anatomy of the kidney, well chosen and fairly tracks of the percutaneous nephrostomy (PN), training, experience and good techniques in endoscopy of the kidney and the ureter.