Treatment of staghorn stones is challenging for urologists due to the difficulty of removing all of the stones. Percutaneous nephrolithotomy (PCNL) is recommended as the first choice for the treatment of staghorn stones by the American Urological Association. We present our experience in single-access percutaneous nephrolithotomy for staghorn stones at our hospital.

Prospectively reviewed cases of 69 patients who had single access percutaneous nephrolithotomy were performed between February 2017 and December 2024. 38 renal units had a complete staghorn and 31 had a partial staghorn. The mean age of patients was 52.5 ± 11.6 (range, 27-80) years; 40 were males and 29 were females. The mean length of the stone was 45.1 ± 12 (range, 36-78) mm. Isolated lower pole access was used in all cases. The operation was performed in a single stage, with biplanar C-arm assistance. A follow-up KUB check was taken 1 day and 1 month after the operation to evaluate the stone-free status.

In total, 49 patients (71%) were successfully treated with PCNL alone. The residual stone rates were 29%. A complete stone clearance rate was increased to 79.9% after a second look procedure (n=11) and a ureteroscopy (n=7). The Mean operative time was 54.6 ± 22.5 (range, 25-95) minutes. The mean hospital stay was 4.9 ± 1.8 (range, 2-9) days. The overall complications rate was 13%, with 9 patients experiencing Clavien-Dido grade I or grade II complications. 2 patients experienced bleeding requiring a transfusion. The mean decrease in hemoglobin level was 2.05 ± 1.57 g/dl. There was no mortality.

Single-access percutaneous nephrolithotomy was a safe and efficacy procedure for the management of staghorn stones.