Objective To compare the efficacy and safety of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal staghorn calculi. Methods Clinical data of 89 patients with renal staghorn calculi treated with RIRS (RIRS group

42 cases) and PCNL (PCNL group

47 cases) in our hospital from September 2016 to January 2019 were retrospectively analyzed.The operative time

intraoperative blood loss

percentage of blood transfusion

decrease of hemoglobin after surgery

success rate of lithotripsy

length of stay after surgery

total hospitalization cost and complications of the two groups were compared. Results The operation time of RIRS group and PCNL group was (140.3±47.1) min and (115.2±43.6) min respectively;the intraoperative blood loss volume was (30.2±6.7) mL and (39.6±8.3) mL respectively;the postoperative hemoglobin decrease was (0.95±0.67) g/L and (1.66±1.07) g/L respectively;the total hospitalization cost was (21.3±6.7) thousand yuan and (25.4±6.2) thousand yuan respectively;the hospitalization after operation was (2.8±1.3) days and (5.6±1.6) days respectively;the percentage of blood transfusion was 0 and 4.25% (2/47);and the success rate of first stage lithotomy was 78.6% (33/42) and 85.1%(40/47)

respectively.All the above differences were statistically significant (P<0.05).There was no significant difference in rate of stone clearance and incidence of complications between the two groups (P>0.05).Among these patients

7 patients in RIRS group and 4 patients in PCNL group received EWSLassisted lithotripsy after operation. Conclusion Both RIRS and PCNL are efficient and safe alteration for patients with renal staghorn calculi.Although the operation time of RIRS is relatively long

it has fewer intraoperative bleeding

faster postoperative recovery

lower hospitalization costs and higher safety.