@article{3107993,
    title = "Single lower calyceal percutaneous tract combined with flexible nephroscopy: A valuable treatment paradigm for staghorn stones",
    author = "Sfoungaristos, S. and Mykoniatis, I. and Katafigiotis, I. and Isid, A. and Gofrit, O.N. and Constantinides, C.A. and Duvdevani, M.",
    journal = "Canadian Urological Association Journal",
    year = "2018",
    volume = "12",
    number = "1",
    pages = "E21-E24",
    publisher = "Canadian Urological Association Central Office",
    issn = "1911-6470",
    doi = "10.5489/cuaj.4393",
    keywords = "antibiotic agent;  opiate, adult;  Article;  blood transfusion;  cohort analysis;  computer assisted tomography;  disease free survival;  endoscopy;  female;  fever;  fluoroscopy;  human;  kidney calyx;  length of stay;  major clinical study;  male;  medical decision making;  medical record review;  middle aged;  nephroscopy;  operation duration;  patient safety;  percutaneous nephrolithotomy;  postoperative complication;  postoperative hemorrhage;  postoperative pain;  postoperative period;  postoperative thrombosis;  retrospective study;  staghorn stone;  treatment outcome;  ureteral stenting;  urine incontinence",
    abstract = "Introduction: We evaluated the efficacy and safety of single lower calyceal tract combined with flexible nephroscopy for the management of staghorn renal stones by percutaneous nephrolithotomy. Methods: The medical records of patients who underwent percutaneous nephrolithotomy for the management of staghorn stones were analyzed. We included patients aged >18 years, while patients with incomplete data and renal anatomical anomalies were excluded from the study. Stone-free rate, postoperative complications, procedure duration, fluoroscopy time, and length of hospitalization were recorded. Postoperative outcomes were evaluated by non-contrast computed tomography scan 4-6 weeks after the operation. Stonefree status was defined as the absence of residual stones >4 mm. Results: The study cohort consisted of 103 consecutive patients. Stonefree rate was 65.0%. No complications were observed in 69.9% of the cases; most postoperative complications were Grade 1 (13.6%) and 2 (10.7%). Five patients (4.9%) suffered a Grade 3a complication and another patient (1.0%) suffered a Grade 3b complication. Conclusions: Percutaneous nephrolithotomy through a single lower calyceal tract combined with flexible nephroscopy can be a valuable treatment option for the treatment of staghorn calculi, providing efficacy and safety. Nevertheless, the present study is limited by both its retrospective nature and being conducted at a single centre and, thus, proper prospective studies with head-on comparisons are needed to prove or disprove the advantages and disadvantages of either approach. © 2018 Canadian Urological Association."
}