Outcomes of percutaneous nephrolithotomy versus open stone surgery for patients with staghorn calculi

Objectives: Advances in shock wave lithotripsy and endourological procedures have markedly limited the need for open surgery in the treatment of renal stones. We retrospectively compared the clinical outcomes of percutaneous nephrolithotomy (PNL)-based therapy with open stone surgery (OSS) to treat staghorn stones. Materials and methods: Hospital and office charts, operative records, and radiographic studies of all patients undergoing OSS (Group 1, 11 patients) and PNL (Group 2, 61 patients) for the treatment of large staghorn calculi from 2007 to 2013 were reviewed. Only patients with stones ≥ 10 cm2 in area were included. Patient characteristics, stone burden, indications, and surgical outcomes between the two procedures were compared. Stone-clearance was confirmed using postoperative kidney, ureter, bladder X-rays. Results: There were no differences between the two groups in patient demographics, stone size, estimated blood loss, and mean renal function level change, however, there were statistically significant differences in mean operative time (282.1±54.5 minutes vs. 156.6±41.2 minutes, p