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

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrolithiasis Treatment

Background:

• Renal stones pose a significant health challenge, necessitating effective treatment options.
• Percutaneous nephrolithotomy (PNL) is a primary surgical approach for kidney stones.
• Mini-PNL and standard-PNL represent different techniques with varying outcomes.

Purpose of the Study:

• To compare the efficacy and safety of mini-percutaneous nephrolithotomy (Mini-PNL) versus standard-PNL for treating renal stones.
• To evaluate differences in stone-free rate (SFR), operative time, complications, and hospital stay between the two PNL techniques.

Main Methods:

• A retrospective study comparing 378 Mini-PNL cases with 151 standard-PNL cases.
• Procedures utilized pneumatic lithotripsy with specific tract sizes and instrumentation for each group.
• Statistical analysis included Student's t-test, Mann-Whitney, Chi-square, Fisher's exact tests, and logistic regression (p < 0.05 significant).

Main Results:

• Mini-PNL demonstrated significantly lower complication rates (7.9% vs. 20.5%) and shorter hospital stays (2.43 vs. 4.29 days).
• Standard-PNL achieved a significantly higher stone-free rate (96% vs. 89.9%), particularly for multiple or large stones (>2 cm²).
• Mini-PNL had a longer operative time but a higher rate of tubeless procedures (75.1% vs. 4.6%).

Conclusions:

• Mini-PNL offers a favorable safety profile with reduced complications and shorter hospitalization compared to standard-PNL.
• While standard-PNL shows a higher stone-free rate, Mini-PNL provides clinically comparable results for single or smaller stones.
• The choice between Mini-PNL and standard-PNL should consider stone characteristics, aiming to balance efficacy with reduced morbidity.