Effect of multiple-tract mini-percutaneous nephrolithotomy on kidney function for the treatment of renal complex...

To demonstrate the safety and efficacy of multiple-tract mini-percutaneous nephrolithotomy (mini-PCNL) on kidney function for the treatment of renal complex stones.

From March 2019 to August 2023, 157 patients were treated with multiple-tract mini-PCNL at a single center. The clinical database was gathered in a retrospective manner, and the outcomes were recorded. All surgeries were performed by a urologist who had experience.

The average stone burden was 1383.3 mm² and the mean stone size was 56.9 mm. There were 60 (38.2%) and 97 (61.8%) patients with staghorn stones and multiple stones, respectively. 64 (41.8%) patients were discharged within 24 h after surgery and 93 patients (58.2%) required full admission (longer than 24 h). Seven cases (4.5%) required readmission. The change in postoperative serum creatinine was - 0.7 ± 51.0 µmol/L and postoperative laterality GFR was 29.5 ± 15.3 ml/min/1.73m². There were 95 (60.5%) patients and 44 (28.0%) patients with stable kidney function and improved kidney function after surgery, respectively, and 18 (11.5%) cases with decreased kidney function. The established tract size ranged from 16 to 20 Fr. Mean operative time was 130.9 ± 47.9 min with a hemoglobin drop of 19.7 ± 14.1 g/L, and the incidence of drop ≥ 25 g/L was 28.0%. 33 patients (21.0%) developed postoperative complications with severe complications (Clavien grades III-IV) in 6 cases (3.8%), such a bleeding (5 cases), urosepsis with pleural effusion and gross hematuria (1 case).

Multiple-tract mini-PCNL performed by experienced surgeons can be considered as a safe and feasible treatment method for treating complex kidney calculi.