Efficacy and Safety of Vacuum‐Assisted Access Sheath in Single‐Tract or Multitract Percutaneous Nephrolithotomy for Partial and Complete Staghorn Stones: A Single‐Center Experience

Objectives To evaluate the efficacy and safety of using the vacuum‐assisted access sheaths in single‐tract and multitract percutaneous nephrolithotomy (PCNL) for the treatment of staghorn stones. Methods This retrospective study analyzed 216 patients with partial or complete staghorn stones who underwent single‐tract or multitract PCNL. Patients were divided into two groups based on the use of vacuum‐assisted access sheaths: the vacuum‐assisted PCNL (VA) group and traditional PCNL (Control) group. Pre‐, intra‐, and postoperative data were analyzed using t ‐test, Pearson chi‐square, and Fischer exact statistical measures. Results There was no significant difference in stone‐free rate (SFR) in both groups. In single‐tract PCNL, the VA group had higher rates of normal blood routine (93.3% vs. 63.6%, p < 0.001), fewer infections (4.4% vs 21.2%, p = 0.01), shorter operating times (94.3 ± 25.9 min vs. 112.0 ± 39.9 min, p = 0.01), and faster recovery (5.0 ± 1.4 days vs. 5.8 ± 1.6 days, p = 0.01). In multitract PCNL, the trend toward lower infection rates with suction did not reach statistical significance ( p = 0.28). Logistic regression showed that vacuum assistance significantly reduced the odds of infectious complications (OR = 0.343, p = 0.02). Conclusions Vacuum‐assisted access sheath in single‐tract PCNL significantly reduces infection rate, operating time, and recovery time in staghorn calculi patients. However, the vacuum‐assisted access sheath is used in the main tract but not in other tracts during the multitract PCNL, and its benefit in reducing postoperative infections is limited.