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Minituriazed percutaneous nephrolithotomy: what does it mean?

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Abstract

A lot of interest has been recently attracted to miniaturized Percutaneous Nephrolithotomy (PCNL). Smaller diameter tracts and instruments, in comparison to standard PCNL are utilized to decrease the morbidity of PCNL. However, a debate is ongoing regarding the safety and efficacy of these methods. The growing enthusiasm toward miniaturized PCNL led to different techniques and instruments, and eventually generated confusion in the terminology of PCNL. In this review, we highlight the different modalities of miniaturized PCNL, their indication, their safety and efficacy, and the appropriate terminology is suggested. A comprehensive review of current literature was performed using PubMed®. Publications relevant to the subject were retrieved and critically appraised. Miniaturized PCNL was introduced with the desire to reduce access-related complications and bleeding. Miniaturized PCNL has yet to prove clear advantage over the standard PCNL. Nevertheless, the current experience proves the safety of the miniaturized techniques. Advantages of the miniaturized PCNL suggested in the literature are the lower bleeding rate and decreased hospital stay. In addition, the miniaturized PCNL has been proven a safe and effective modality of renal stone treatment in pediatric population.

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References

  1. Alken P, Hutschenreiter G, Gunther R (1982) Percutaneous kidney stone removal. Eur Urol 8(5):304–311

    CAS  PubMed  Google Scholar 

  2. Segura JW, Patterson DE, LeRoy AJ, Williams HJ Jr, Barrett DM, Benson RC Jr, May GR, Bender CE (1985) Percutaneous removal of kidney stones: review of 1000 cases. J Urol 134(6):1077–1081

    CAS  PubMed  Google Scholar 

  3. Rassweiler J, Gumpinger R, Miller K, Holzermann F, Eisenberger F (1986) Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease. Eur Urol 12(5):294–304

    CAS  PubMed  Google Scholar 

  4. Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW (1998) The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 16(6):371–374

    Article  CAS  PubMed  Google Scholar 

  5. Nagele U, Schilling D, Anastasiadis AG, Corvin S, Seibold J, Kuczyk M, Stenzl A, Sievert KD (2006) Closing the tract of mini-percutaneous nephrolithotomy with gelatine matrix hemostatic sealant can replace nephrostomy tube placement. Urology 68(3):489–493. doi:10.1016/j.urology.2006.03.081 (discussion 493–484)

    Article  PubMed  Google Scholar 

  6. Lahme S, Zimmermanns V, Hochmuth A, Janitzki V (2008) Minimally invasive PCNL (mini-perc). Alternative treatment modality or replacement of conventional PCNL? Der Urologe Ausg A 47(5):563–568. doi:10.1007/s00120-008-1708-3

    Article  CAS  PubMed  Google Scholar 

  7. Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M (2011) The “all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol 59(6):1054–1059. doi:10.1016/j.eururo.2011.03.026

    Article  PubMed  Google Scholar 

  8. Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M (2011) Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol 186(1):140–145. doi:10.1016/j.juro.2011.03.029

    Article  PubMed  Google Scholar 

  9. Lu Y, Ping JG, Zhao XJ, Hu LK, Pu JX (2013) Randomized prospective trial of tubeless versus conventional minimally invasive percutaneous nephrolithotomy. World J Urol 31(5):1303–1307. doi:10.1007/s00345-012-0921-2

    Article  PubMed  Google Scholar 

  10. Mishra S, Sharma R, Garg C, Kurien A, Sabnis R, Desai M (2011) Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int 108(6):896–899. doi:10.1111/j.1464-410X.2010.09936.x (discussion 899–900)

    PubMed  Google Scholar 

  11. Knoll T, Wezel F, Michel MS, Honeck P, Wendt-Nordahl G (2010) Do patients benefit from miniaturized tubeless percutaneous nephrolithotomy? A comparative prospective study. J Endourol Endourol Soc 24(7):1075–1079. doi:10.1089/end.2010.0111

    Article  Google Scholar 

  12. Sabnis RB, Ganesamoni R, Doshi A, Ganpule AP, Jagtap J, Desai MR (2013) Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial. BJU Int 112(3):355–361. doi:10.1111/bju.12164

    Article  PubMed  Google Scholar 

  13. Yamaguchi A, Skolarikos A, Buchholz NP, Chomon GB, Grasso M, Saba P, Nakada S, de la Rosette J (2011) Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol Endourol Soc 25(6):933–939. doi:10.1089/end.2010.0606

    Article  Google Scholar 

  14. Desai J, Zeng G, Zhao Z, Zhong W, Chen W, Wu W (2013) A novel technique of ultra-mini-percutaneous nephrolithotomy: introduction and an initial experience for treatment of upper urinary calculi less than 2 cm. BioMed Res Int 2013:490793. doi:10.1155/2013/490793

    Article  PubMed  PubMed Central  Google Scholar 

  15. Nagele U, Schilling D, Anastasiadis AG, Walcher U, Sievert KD, Merseburger AS, Kuczyk M, Stenzl A (2008) Minimally invasive percutaneous nephrolitholapaxy (MIP). Der Urologe Ausg A 47(9):1068–1073. doi:10.1007/s00120-008-1814-2

    Article  Google Scholar 

  16. Sabnis RB, Ganesamoni R, Ganpule AP, Mishra S, Vyas J, Jagtap J, Desai M (2013) Current role of microperc in the management of small renal calculi. Ind J Urol IJU J Urol Soc India 29(3):214–218. doi:10.4103/0970-1591.117282

    Article  Google Scholar 

  17. Schilling D, Husch T, Bader M, Herrmann TR, Nagele U (2015) Nomenclature in PCNL or the tower of Babel: a proposal for a uniform terminology. World J Urol 33(11):1905–1907. doi:10.1007/s00345-015-1506-7

    Article  PubMed  Google Scholar 

  18. Tepeler A, Sarica K (2013) Standard, mini, ultra-mini, and micro percutaneous nephrolithotomy: what is next? A novel labeling system for percutaneous nephrolithotomy according to the size of the access sheath used during procedure. Urolithiasis 41(4):367–368. doi:10.1007/s00240-013-0578-3

    Article  PubMed  Google Scholar 

  19. Nagele U, Schilling D, Sievert KD, Stenzl A, Kuczyk M (2008) Management of lower-pole stones of 0.8 to 1.5 cm maximal diameter by the minimally invasive percutaneous approach. J Endourol Endourol Soc 22(9):1851–1853. doi:10.1089/end.2008.9791

    Article  Google Scholar 

  20. Kirac M, Bozkurt OF, Tunc L, Guneri C, Unsal A, Biri H (2013) Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in management of lower-pole renal stones with a diameter of smaller than 15 mm. Urolithiasis 41(3):241–246. doi:10.1007/s00240-013-0552-0

    Article  PubMed  Google Scholar 

  21. Long Q, Guo J, Xu Z, Yang Y, Wang H, Zhu Y, Zhang Y, Wang G (2013) Experience of mini-percutaneous nephrolithotomy in the treatment of large impacted proximal ureteral stones. Urol Int 90(4):384–388. doi:10.1159/000343668

    Article  CAS  PubMed  Google Scholar 

  22. Yang Z, Song L, Xie D, Hu M, Peng Z, Liu T, Du C, Zhong J, Qing W, Guo S, Zhu L, Yao L, Huang J, Fan D, Ye Z (2012) Comparative study of outcome in treating upper ureteral impacted stones using minimally invasive percutaneous nephrolithotomy with aid of patented system or transurethral ureteroscopy. Urology 80(6):1192–1197. doi:10.1016/j.urology.2012.08.045

    Article  PubMed  Google Scholar 

  23. Zhong W, Zeng G, Wu W, Chen W, Wu K (2011) Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res 39(2):117–122. doi:10.1007/s00240-010-0308-z

    Article  PubMed  Google Scholar 

  24. Zeng G, Zhao Z, Wan S, Mai Z, Wu W, Zhong W, Yuan J (2013) Minimally invasive percutaneous nephrolithotomy for simple and complex renal caliceal stones: a comparative analysis of more than 10,000 cases. J Endourol Endourol Soc 27(10):1203–1208. doi:10.1089/end.2013.0061

    Article  Google Scholar 

  25. Monga M, Oglevie S (2000) Minipercutaneous nephrolithotomy. J Endourol Endourol Soc 14(5):419–421

    Article  CAS  Google Scholar 

  26. Chan DY, Jarrett TW (2000) Mini-percutaneous nephrolithotomy. J Endourolo Endourol Soc 14(3):269–272 (discussion 272–263)

    Article  CAS  Google Scholar 

  27. Desai MR, Kukreja RA, Patel SH, Bapat SD (2004) Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourolo Endourol Soc 18(1):23–27. doi:10.1089/089277904322836613

    Article  Google Scholar 

  28. Jackman SV, Hedican SP, Peters CA, Docimo SG (1998) Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 52(4):697–701

    Article  CAS  PubMed  Google Scholar 

  29. Desai J, Solanki R (2013) Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU Int 112(7):1046–1049. doi:10.1111/bju.12193

    PubMed  Google Scholar 

  30. Zeng G, Wan S, Zhao Z, Zhu J, Tuerxun A, Song C, Zhong L, Liu M, Xu K, Li H, Jiang Z, Khadgi S, Pal SK, Liu J, Zhang G, Liu Y, Wu W, Chen W, Sarica K (2015) Super-mini percutaneous nephrolithotomy (SMP): a new concept in technique and instrumentation. BJU Int. doi:10.1111/bju.13242

    PubMed  Google Scholar 

  31. Desai M, Mishra S (2012) ‘Microperc’ micro percutaneous nephrolithotomy: evidence to practice. Curr Opin Urol 22(2):134–138. doi:10.1097/MOU.0b013e32834fc3bb

    Article  PubMed  Google Scholar 

  32. Mulvaney WP (1963) The hydrodynamics of renal irrigations: with reference to calculus solvents. J Urol 89:765–768

    CAS  PubMed  Google Scholar 

  33. Stenberg A, Bohman SO, Morsing P, Muller-Suur C, Olsen L, Persson AE (1988) Back-leak of pelvic urine to the bloodstream. Acta Physiol Scand 134(2):223–234. doi:10.1111/j.1748-1716.1988.tb08483.x

    Article  CAS  PubMed  Google Scholar 

  34. Tepeler A, Akman T, Silay MS, Akcay M, Ersoz C, Kalkan S, Armagan A, Sarica K (2014) Comparison of intrarenal pelvic pressure during micro-percutaneous nephrolithotomy and conventional percutaneous nephrolithotomy. Urolithiasis 42(3):275–279. doi:10.1007/s00240-014-0646-3

    Article  PubMed  Google Scholar 

  35. Traxer O, Smith TG 3rd, Pearle MS, Corwin TS, Saboorian H, Cadeddu JA (2001) Renal parenchymal injury after standard and mini percutaneous nephrostolithotomy. J Urol 165(5):1693–1695

    Article  CAS  PubMed  Google Scholar 

  36. Li LY, Gao X, Yang M, Li JF, Zhang HB, Xu WF, Lin Z (2010) Does a smaller tract in percutaneous nephrolithotomy contribute to less invasiveness? A prospective comparative study. Urology 75(1):56–61. doi:10.1016/j.urology.2009.06.006

    Article  PubMed  Google Scholar 

  37. Cheng F, Yu W, Zhang X, Yang S, Xia Y, Ruan Y (2010) Minimally invasive tract in percutaneous nephrolithotomy for renal stones. J Endourol Endourol Soc 24(10):1579–1582. doi:10.1089/end.2009.0581

    Article  Google Scholar 

  38. Giusti G, Piccinelli A, Taverna G, Benetti A, Pasini L, Corinti M, Teppa A, Zandegiacomo de Zorzi S, Graziotti P (2007) Miniperc? No, thank you! Eur Urol 51(3):810–814. doi:10.1016/j.eururo.2006.07.047 (discussion 815)

    Article  PubMed  Google Scholar 

  39. Sabnis RB, Jagtap J, Mishra S, Desai M (2012) Treating renal calculi 1–2 cm in diameter with minipercutaneous or retrograde intrarenal surgery: a prospective comparative study. BJU Int 110(8 Pt B):E346–E349. doi:10.1111/j.1464-410X.2012.11089.x

    Article  PubMed  Google Scholar 

  40. Zeng G, Zhu W, Li J, Zhao Z, Zeng T, Liu C, Liu Y, Yuan J, Wan SP (2015) The comparison of minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery for stones larger than 2 cm in patients with a solitary kidney: a matched-pair analysis. World J Urol 33(8):1159–1164. doi:10.1007/s00345-014-1420-4

    Article  PubMed  Google Scholar 

  41. Pan J, Chen Q, Xue W, Chen Y, Xia L, Chen H, Huang Y (2013) RIRS versus mPCNL for single renal stone of 2–3 cm: clinical outcome and cost-effective analysis in Chinese medical setting. Urolithiasis 41(1):73–78. doi:10.1007/s00240-012-0533-8

    Article  PubMed  Google Scholar 

  42. Kruck S, Anastasiadis AG, Herrmann TR, Walcher U, Abdelhafez MF, Nicklas AP, Holzle L, Schilling D, Bedke J, Stenzl A, Nagele U (2013) Minimally invasive percutaneous nephrolithotomy: an alternative to retrograde intrarenal surgery and shockwave lithotripsy. World J Urol 31(6):1555–1561. doi:10.1007/s00345-012-0962-6

    Article  PubMed  Google Scholar 

  43. Zeng G, Zhao Z, Wan S, Zhong W, Wu W (2013) Comparison of children versus adults undergoing mini-percutaneous nephrolithotomy: large-scale analysis of a single institution. PLoS One 8(6):e66850. doi:10.1371/journal.pone.0066850

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Zeng G, Jia J, Zhao Z, Wu W, Zhao Z, Zhong W (2012) Treatment of renal stones in infants: comparing extracorporeal shock wave lithotripsy and mini-percutaneous nephrolithotomy. Urol Res 40(5):599–603. doi:10.1007/s00240-012-0478-y

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University Hospital of Patras, University of Patras, 26504, Patras, Greece

    W. Kamal, P. Kallidonis, I. Kyriazis & E. Liatsikos

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  1. W. Kamal
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  2. P. Kallidonis
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Correspondence to P. Kallidonis.

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Kamal, W., Kallidonis, P., Kyriazis, I. et al. Minituriazed percutaneous nephrolithotomy: what does it mean?. Urolithiasis 44, 195–201 (2016). https://doi.org/10.1007/s00240-016-0881-x

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