Combined micro-and standard percutaneous nephrolithotomy for complex renal calculi

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Complex renal calculi present a significant management challenge.
• Standard percutaneous nephrolithotomy (PNL) is effective but can have limitations for large or complex stones.

Purpose of the Study:

• To evaluate the efficacy and safety of combining standard PNL with microperc for complex kidney stones.
• To assess if this combined approach improves stone-free rates without increasing complications.

Main Methods:

• Retrospective evaluation of patients undergoing combined standard PNL and microperc for complex kidney stones (2013-2015).
• Analysis of operative time, fluoroscopy time, stone-free status, and complication rates.

Main Results:

• A stone-free rate of 78.2% was achieved, with 13.1% having residual fragments ≤4 mm.
• The average operative time was 88.2 minutes and fluoroscopy time was 5.3 minutes.
• Complications occurred in 13% of patients (1 hemorrhage, 2 postoperative fevers).

Conclusions:

• The combination of standard PNL and microperc may increase success rates for complex renal calculi.
• This technique might potentially reduce complication rates compared to standard PNL alone.
• Further prospective and comparative studies are warranted to confirm these findings.