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Abstract

Staghorn calculi represent a complex and challenging form of renal stone disease requiring effective surgical management. Both mini-percutaneous nephrolithotomy (mPCNL) and conventional percutaneous nephrolithotomy (cPCNL) are widely used techniques; however, their comparative efficacy in the management of complete staghorn stones remains under investigation.To compare the stone-free rates and outcomes of mPCNL versus cPCNL in patients with complete staghorn renal calculi. A randomized controlled trial was conducted at the Department of Urology, Institute of Kidney Diseases, Peshawar, from May 8, 2023, to November 7, 2023. A total of 112 patients with complete staghorn calculi were enrolled and randomized into two equal groups (56 patients each): Group A underwent mPCNL, and Group B underwent cPCNL. Patient demographics, stone characteristics, and surgical outcomes were recorded. The primary endpoint was stone-free status, assessed one month postoperatively via non-contrast CT KUB. Data was analyzed using SPSS v25.0, with a significance threshold of p < 0.05. The mean age was 39.05 ± 11.07 years in the mPCNL group and 40.02 ± 12.87 years in the cPCNL group (p = 0.672). No significant differences were observed in gender distribution, stone laterality, or mean stone size between groups. Complete stone clearance was achieved in 85.7% of patients in the mPCNL group and 91.1% in the cPCNL group (p = 0.378). Stratified analyses based on age, gender, stone side, and stone size showed no statistically significant differences in efficacy across subgroups. Both mPCNL and cPCNL demonstrated comparable efficacy in the management of complete staghorn stones, with high stone-free rates and no significant differences in clinical or demographic variables. Further large-scale, multicenter studies with long-term follow-up are warranted to validate these results.