[Assessment of the safety and efficacy of mini-percutaneous nephrolithotomy]

To evaluate the efficacy and safety of mini-percutaneous nephrolithotripsy (mini-PCNL) depending on stone size, location, density, and the fragmentation method used.

A prospective analysis was performed of the treatment outcomes of 232 patients with urolithiasis treated at the Republican Specialized Scientific and Practical Medical Center of Urology between 2024 and 2026. The mean age of the patients was 34.3+/-15.4 years. All patients underwent mini-PCNL under fluoroscopic guidance using endourological instruments manufactured by Karl Storz (Germany) according to the standard technique.

With a mean stone size of 13.7+/-6.4 mm (range 6-54 mm), the stone-free rate (SFR) was 92.2%. In patients with stones less or equal 10 mm, 11-20 mm, and >21 mm, the SFR was 98.8%, 96.1%, and 47.8%, respectively (p<0.001). Intraoperative and postoperative complications, as well as repeat procedures required to manage complications, were observed in patients with stones located in the renal pelvis and in those with staghorn calculi. An SFR of 100% was achieved for stones located in the middle and lower calyces. The incidence of postoperative complications and the absorbed radiation dose depended on stone density. Holmium laser lithotripsy was associated with a low absorbed radiation dose and a high SFR.

Holmium laser mini-PCNL is a safe and effective treatment for renal stones up to 20 mm in size and is associated with low rates of intraoperative and postoperative complications, a low absorbed radiation dose, and a high SFR. The safety and efficacy of mini-PCNL were significantly lower in patients with renal stones >21 mm and staghorn calculi due to higher rates of intraoperative and postoperative complications, the need for additional interventions, a higher absorbed radiation dose, and a lower SFR.