Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study

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04 January 2019

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doi: 10.1007/s00240-018-1055-9


To compare the outcome of mini-percutaneous nephrolithotomy (Mini-PNL) versus standard-PNL for renal stones. Retrospective study was performed between March 2010 and May 2013 for patients treated by Mini-PNL or standard-PNL through 18 and 30 Fr tracts, respectively, using pneumatic lithotripsy. Semirigid ureteroscope (8.5/11.5 Fr) was used for Mini-PNL and 24 Fr nephroscope for standard-PNL. Both groups were compared in stone free rate(SFR), complications and operative time using Student-t, Mann-Whitney, Chi square or Fisher's exact tests as appropriate in addition to logistic regression analysis. P < 0.05 was considered statistically significant. Mini-PNL (378) and standard-PNL (151) were nearly comparable in patients and stones criteria including stone burden (3.77 ± 2.21 vs 3.77 ± 2.43 cm2; respectively). There was no significant difference in number of tracts or supracostal puncture. Mini-PNL had longer operative time (68.6 ± 29.09 vs 60.49 ± 11.38 min; p = 0.434), significantly shorter hospital stay (2.43 ± 1.46 vs 4.29 ± 1.28 days) and significantly higher rate of tubeless PNL (75.1 vs 4.6%). Complications were significantly higher in standard-PNL (7.9 vs 20.5%; p < 0.001). SFR was significantly lower in Mini-PNL (89.9 vs 96%; p = 0.022). This significant difference was found with multiple stones and large stone burden (> 2 cm2), but the SFR was comparable between both groups with single stone or stone burden ≤ 2 cm. Logistic regression analysis confirmed significantly higher complications and SFR with standard-PNL but with significantly shorter operative time. Mini-PNL has significantly lower SFR when compared to standard-PNL (but clinically comparable) with markedly reduced complications and hospital stay. Most of cases can be performed tubeless. The significant difference in SFR was found with multiple stones or large stone burden (> 2 cm2), but not with single stones or stone burden ≤ 2 cm2.

Keywords: Mini-PNL; Mini-percutaneous nephrolithotomy; Miniperc; Percutaneous nephrolithotomy; Renal stones.


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References

  1.  
    1. Eur Urol. 2001 Dec;40(6):619-24 - PubMed
  2.  
    1. J Urol. 2002 Oct;168(4 Pt 1):1348-51 - PubMed
  3.  
    1. Eur Urol. 2007 Mar;51(3):810-4; discussion 815 - PubMed
  4.  
    1. J Endourol. 2008 Sep;22(9):2147-51 - PubMed
  5.  
    1. Urology. 2010 Jan;75(1):56-61 - PubMed
  6.  
    1. J Endourol. 2010 Jul;24(7):1075-9 - PubMed
  7.  
    1. Urol Res. 2011 Apr;39(2):117-22 - PubMed
  8.  
    1. J Endourol. 2010 Oct;24(10):1579-82 - PubMed
  9.  
    1. BJU Int. 2011 Sep;108(6):896-9; discussion 899-900 - PubMed
  10.  
    1. J Endourol. 2011 Jun;25(6):933-9 - PubMed
  11.  
    1. J Endourol. 2011 Aug;25(8):1281-6 - PubMed
  12.  
    1. Urology. 2013 Feb;81(2):241-5 - PubMed
  13.  
    1. World J Urol. 2014 Oct;32(5):1275-80 - PubMed
  14.  
    1. Urolithiasis. 2015 Nov;43(6):563-70 - PubMed
  15.  
    1. Scand J Urol. 2016 Jun;50(3):212-5 - PubMed
  16.  
    1. Urolithiasis. 2017 Dec;45(6):585-589 - PubMed
  17.  
    1. Acta Physiol Scand. 1988 Oct;134(2):223-34 - PubMed
  18.  
    1. Urology. 1998 Oct;52(4):697-701 - PubMed