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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.
Abstract:
The purpose was to do a study to compare infectious complications in patients operated for MiniPerc or Minimally invasive Percutaneous Nephrolithotomy (MPCNL) using MIP and MPCNL with suction using Shah Superperc sheath for medium-sized renal stones less than 3 cm in size. The primary objective of this study is to compare the infectious complications and the secondary objectives are to compare stone-free rates, complication rates and operative times. A prospective randomized controlled trial with patients having proximal ureteral and renal stones of 10-30 mm size and planned for MPCNL done at a single institute. A total of 80 consecutively admitted patients with written informed consent were included for randomization with 40 patients in each arm of MPCNL and suction MPCNL. The median age in MPCNL and suction MPCNL arms were 48 and 49 years, the median stone size of 15.45 and 16.7 cm, the Median stone volume of 1576.2 vs 1752 mm3, and the median stone density of 1258 and 1250 Hu, the median hospital stay of 3 days in both arms were comparable. Infectious complications were comparable in both arms. Operative time was significantly less in the suction MPCNL group (26.5 min-IQR 17-34.8) than in the MPCNL group (34.8 min-IQR 20-45), p = 0.021 and stone-free rates (SFR), were more in Suction MPCNL arm 97.5% than in MPCNL 87.5%, p = 0.04. Overall, the complication rates were comparable in both arms. Suction MPCNL procedure resulted in shorter operating times and more SFR than conventional MPCNL with comparable complication rates.
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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