A randomized controlled trial comparing infectious complications using mini perc with and without suction for renal

Niramya Pathak1, Sahil Agrawal1, Aditya Parikh1

  • 1Urology Department, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.

Urolithiasis
|November 22, 2023
PubMed

Insights

Suction-assisted minimally invasive percutaneous nephrolithotomy (MPCNL) reduces operative time and improves stone-free rates compared to standard MPCNL for kidney stones under 3 cm. Infectious complications and overall complication rates were similar between both techniques.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithotomy

Background:

  • Minimally invasive percutaneous nephrolithotomy (MPCNL) is a standard treatment for kidney stones.
  • Optimizing MPCNL techniques to improve outcomes and reduce complications is an ongoing area of research.

Purpose of the Study:

  • To compare infectious complications between standard MPCNL and suction-assisted MPCNL for medium-sized renal stones (<3 cm).
  • To evaluate secondary outcomes including stone-free rates, overall complication rates, and operative times.

Main Methods:

  • A prospective randomized controlled trial involving 80 patients with renal or proximal ureteral stones (10-30 mm).
  • Patients were randomized into two groups: standard MPCNL (n=40) and suction-assisted MPCNL (n=40).
  • Data collected included infectious complications, stone-free rates, overall complications, and operative times.

Main Results:

  • Operative time was significantly shorter in the suction-assisted MPCNL group (26.5 min) compared to the standard MPCNL group (34.8 min) (p=0.021).
  • Stone-free rates were higher in the suction-assisted MPCNL group (97.5%) than in the standard MPCNL group (87.5%) (p=0.04).
  • Infectious complications and overall complication rates were comparable between the two groups.

Conclusions:

  • Suction-assisted MPCNL offers advantages over conventional MPCNL, including reduced operative time and improved stone-free rates.
  • The technique is associated with similar infectious and overall complication rates, making it a viable alternative for treating medium-sized renal stones.

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