研究目的：要完全移除完全鹿角結石對泌尿科醫師是一個挑戰。美國泌尿科醫學會建議，經皮腎截石術是治療完全鹿角結石的第一選擇。經皮腎造簍手術自從80年代末期引進台灣以來，已被廣泛使用於腎結石治療。我們報告我們醫院使用經皮腎截石術治療完全鹿角結石的經驗。材料與方法：從1999年7月至2002年12月，一共有234位完全鹿角結石病患在我們醫院接受了249個經皮腎造簍手術。平均年齡是52.4±12.8歲（從14.8歲至77.3歲）；其中145位是男性，89位為女性。平均結石長度為6.1公分（從2.1公分到8.6公分），平均結石寬度為5.0公分（從2.0公分到6.8公分）。手術方法是採用雙平面X光透視協助下，一個步驟完成。如果有殘餘結石，於手術後2週在門診行體外震波碎石術。3個月後於門診追蹤腎－輸尿管－膀胱影像(KUB film)，以評估結石廓清率。結果：結石廓清率，無意義殘餘結石(<4mm)和殘餘結石率分別是74.4%，8.9%和16.7%，整體成功率為83.3%。單純經皮腎截石術後有101位(43.1%)即達到成功。平均手術時間為63.5分鐘（從29分鐘到103分鐘）平均住院天數為5.5天（從3天至17天）。沒有病患死亡且只有少數併發症。最常見的術後併發症為發燒(23.1%)，3位病患因大量出血而接受輸血，一位病患產生動靜脈簍管並接受動脈拴塞。結論：經皮腎截石術治療完全鹿角結石是可行且安全的方法，帶來了高達83.3%的成功率和較少的併發症。

OBJECTIVE: Treatment of complete staghorn stones is challenging for urologists because it is difficult to remove all of the stone. Percutaneous nephrolithotomy (PCNL) is suggested as the first-line treatment for complete staghorn stones by the American Urological Association. PCNL, first introduced to Taiwan in the late 1980s, is now widely used here. We present our experience in treating complete staghorn stones with PCNL at our institution. MATERIALS and METHODS: Between July 1996 and December 2002, 234 patients with a complete staghorn stone underwent 249 PCNL procedures at our institution. The mean age was 52.4±12.8 (range, 14.8~77.3) years; 145 were males and 89 were females. The mean length of the stone was 6.1 (range, 2.1~8.6) cm, and the mean width of the stone was 5.0 (range, 2.0~6.8) cm. The operation was performed in a single stage, with biplanar C-arm assistance. Extracorporeal lithotripsy using a PCK lithotripter was scheduled on an outpatient basis, approximately 2 weeks after PCNL if residual stones were noted on a postoperative kidney, ureter, and bladder (KUB). A follow-up KUB check was taken 3 months after the operation to evaluate the stone-free status. RESULTS: The stone-free rate, insignificant residual stone rate (<4 mm), and residual stone rate at 3 months were 74.4%, 8.9%, and 16.7%, with a success rate of 83.3%. In total, 101 patients (43.1%) were successfully treated with PCNL alone. The mean operative time was 63.5 (range, 29~103) minutes. The mean hospital stay was 5.5 (range, 3~17) days. There was no mortality, and morbidity was minimal. The most-common complication was fever (23.1%); 3 patients experienced massive bleeding requiring a transfusion. One patient had an arteriovenous fistula and was successfully treated with angiographic embolization. CONCLUSION: PCNL is a safe and feasible method for the treatment of complete staghorn stones, achieving a high success rate (83.3%) with minimal complications.