A multi-institutional experience of Micro-percutaneous Nephrolithotomy (MicroPERC) for renal stones: Results and...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrolithiasis Management

Background:

• Nephrolithiasis (kidney stones) management often involves surgical intervention.
• Percutaneous nephrolithotomy (PCNL) is a common treatment, with Microperc representing a less invasive variant.
• Assessing the feasibility and outcomes of Microperc in an outpatient setting is crucial for optimizing patient care pathways.

Purpose of the Study:

• To evaluate the multi-institutional outcomes of the Microperc procedure for kidney stones.
• To determine the feasibility of performing Microperc in an outpatient setting.
• To compare same-day discharge rates and postoperative outcomes between inpatient and outpatient Microperc.

Main Methods:

• Retrospective analysis of adult patients undergoing Microperc for renal stones across three institutions (May 2015 - March 2021).
• Comparison of outcomes between a group managed with a "one-way" outpatient strategy and a group receiving at least one-day inpatient monitoring.
• Primary endpoint: same-day discharge without emergency visits or 30-day readmissions; secondary endpoints: treatment success and complication rates.

Main Results:

• 44.4% of patients (32/72) were discharged on the same day.
• Overall stone-free rate (including residual micro-fragments) was 76.4%, with no significant difference between inpatient (77.5%) and outpatient (75%) groups.
• 30-day complication rates were similar (Clavien I-II: 18.1%, Clavien ≥III: 4.1%), with outpatient immediate/unplanned readmissions at 12.5% (mainly UTI).

Conclusions:

• Outpatient Microperc is a feasible treatment option for selected kidney stone patients.
• Performing Microperc as an outpatient procedure does not significantly compromise postoperative outcomes or treatment efficacy.
• This approach can potentially streamline care pathways and reduce healthcare resource utilization.