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Enhanced super-mini-PCNL (eSMP): low renal pelvic pressure and high stone removal efficiency in a prospective randomized controlled trial

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Abstract

Objective

In the present prospective randomized controlled trial (RCT), enhanced-SMP (eSMP) and conventional Chinese mini-PCNL (mPCNL) were compared to test the low renal pelvic pressure (RPP) and high stone removal efficiency in eSMP.

Materials and methods

Hundred patients with 2–5 cm renal calculus were enrolled. Renal pelvic pressure, operation time, lithotripsy time, removed stone volume, and complications were compared between eSMP and mPCNL statistically.

Results

There was no significant difference in removed stone volume between mPCNL and eSMP (8.09 ± 3.36 vs. 7.88 ± 3.07 mm3, t = 0.320, p = 0.750), lithotripsy time in mPCNL was longer than eSMP (49.6 ± 19.5 vs. 34.9 ± 14.2 min, t = 4.152, p < 0.001), thus stone removal efficiency was higher in eSMP (13.71 ± 1.18 vs. 9.82 ± 1.24 mm3/h, t = 15.499, p < 0.001). Intra-operative RPP in mPCNL was higher than eSMP (17.72 ± 3.33 vs. 12.03 ± 2.37 mmHg, t = 9.524, p < 0.001); accumulated time of backflow status (RPP > 30 mmHg) in mPCNL was longer than eSMP (23.3 ± 16.9 vs. 3.7 ± 4.2 s, t = 7.710, p < 0.001). There was no significant difference in postoperative fever rate between mPCNL and eSMP (12.77% vs. 4.34%, χ2 = 2.095, p = 0.148), nor final stone-free rate (87.2% vs. 91.3%, χ2 = 0.401, p = 0.526). Hospital stay in eSMP was shorter than mPCNL (2.54 ± 0.72 vs. 3.00 ± 0.88, t = 2.724, p = 0.008).

Conclusion

Enhanced SMP (eSMP) was safe and effective in the management of 2–5 cm renal calculus. It can keep a lower renal pelvic pressure and a higher stone removal efficiency when compared to conventional Chinese mini-PCNL.

Clinical trial registration

NC03206515.

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Abbreviations

PCNL:

Percutaneous nephrolithotomy

SMP:

Super mini-PCNL

eSMP:

Enhanced-SMP

mPCNL:

Mini-PCNL

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Funding

This study was supported by Scientific Research Projects of Guangzhou Municipal Education Bureau (1201620038).

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Authors and Affiliations

  1. Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, The First Affiliated Hospital of Guangzhou Medical University, 1 Kangda Road, Haizhu District, Guangzhou, 510230, Guangdong, China

    Wen Zhong, Junjun Wen, Linjie Peng & Guohua Zeng

Authors
  1. Wen Zhong
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  2. Junjun Wen
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  3. Linjie Peng
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  4. Guohua Zeng
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Contributions

WZ: project development, data collection, interpretation of data, and manuscript writing; JJW: data collection, data analysis, and manuscript writing; LJP: data management, data analysis, and table design; GHZ: project development, interpretation of data, manuscript writing, and critical revision of the manuscript.

Corresponding author

Correspondence to Guohua Zeng.

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The authors declare that they have no conflict of interests.

Ethical approval

This study was approved by the Ethics Committee of the first affiliated Hospital of Guangzhou Medical University.

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Informed and written consent was obtained from all participants.

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Zhong, W., Wen, J., Peng, L. et al. Enhanced super-mini-PCNL (eSMP): low renal pelvic pressure and high stone removal efficiency in a prospective randomized controlled trial. World J Urol 39, 929–934 (2021). https://doi.org/10.1007/s00345-020-03263-3

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  • DOI: https://doi.org/10.1007/s00345-020-03263-3

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