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Urolithiasis

, Volume 47, Issue 2, pp 207–214 | Cite as

Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study

  • Mohammed S. ElSheemyEmail author
  • Akram A. Elmarakbi
  • Mohammed Hytham
  • Hamdy Ibrahim
  • Sanjay Khadgi
  • Ahmed M. Al-Kandari
Original Paper

Abstract

To compare the outcome of mini-percutaneous nephrolithotomy (Mini-PNL) versus standard-PNL for renal stones. Retrospective study was performed between March 2010 and May 2013 for patients treated by Mini-PNL or standard-PNL through 18 and 30 Fr tracts, respectively, using pneumatic lithotripsy. Semirigid ureteroscope (8.5/11.5 Fr) was used for Mini-PNL and 24 Fr nephroscope for standard-PNL. Both groups were compared in stone free rate(SFR), complications and operative time using Student-t, Mann–Whitney, Chi square or Fisher’s exact tests as appropriate in addition to logistic regression analysis. P < 0.05 was considered statistically significant. Mini-PNL (378) and standard-PNL (151) were nearly comparable in patients and stones criteria including stone burden (3.77 ± 2.21 vs 3.77 ± 2.43 cm2; respectively). There was no significant difference in number of tracts or supracostal puncture. Mini-PNL had longer operative time (68.6 ± 29.09 vs 60.49 ± 11.38 min; p = 0.434), significantly shorter hospital stay (2.43 ± 1.46 vs 4.29 ± 1.28 days) and significantly higher rate of tubeless PNL (75.1 vs 4.6%). Complications were significantly higher in standard-PNL (7.9 vs 20.5%; p < 0.001). SFR was significantly lower in Mini-PNL (89.9 vs 96%; p = 0.022). This significant difference was found with multiple stones and large stone burden (> 2 cm2), but the SFR was comparable between both groups with single stone or stone burden ≤ 2 cm. Logistic regression analysis confirmed significantly higher complications and SFR with standard-PNL but with significantly shorter operative time. Mini-PNL has significantly lower SFR when compared to standard-PNL (but clinically comparable) with markedly reduced complications and hospital stay. Most of cases can be performed tubeless. The significant difference in SFR was found with multiple stones or large stone burden (> 2 cm2), but not with single stones or stone burden ≤ 2 cm2.

Keywords

Mini-percutaneous nephrolithotomy Mini-PNL Miniperc Percutaneous nephrolithotomy Renal stones 

Abbreviations

PUT

Plain abdominal radiography

Mini-PNL

Mini-percutaneous nephrolithotomy

NCCT

Non-contrast computed tomography scan

PCN

Percutaneous nephrostomy

PNL

Percutaneous nephrolithotomy

SFR

Stone free rate

Standard-PNL

Standard percutaneous nephrolithotomy

SWL

Extracorporeal shockwave lithotripsy

US

Abdominal ultrasonography

Notes

Authors’ contribution

ElSheemy: Protocol/project development, data collection and management, data analysis, manuscript writing/editing. Elmarakbi: Protocol/project development, data collection and management. Hytham: Protocol/project development, data collection. Hamdy Ibrahim: Protocol/project development, data collection. Khadgi: Protocol/project development, data collection and management. Al-Kandari: Protocol/project development, data collection and management.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. No funding source or industrial links and affiliations.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethical committee.

Informed consent

Informed consent was obtained from all the individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Mohammed S. ElSheemy
    • 1
    Email author
  • Akram A. Elmarakbi
    • 2
  • Mohammed Hytham
    • 1
  • Hamdy Ibrahim
    • 3
  • Sanjay Khadgi
    • 4
  • Ahmed M. Al-Kandari
    • 5
  1. 1.Urology department, Kasr Al-Ainy HospitalsCairo UniversityCairoEgypt
  2. 2.Urology DepartmentBani Swaif UniversityBani SwaifEgypt
  3. 3.Urology DepartmentFayoum UniversityFayoumEgypt
  4. 4.Vayodah and Venus International HospitalsKathmanduNepal
  5. 5.Urology DepartmentKuwait UniversityKuwait CityKuwait

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