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Minimally Invasive (“Mini”) Percutaneous Nephrolithotomy: Classification, Indications, and Outcomes

  • Minimally Invasive Surgery (T Guzzo, Section Editor)
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Abstract

Minimally invasive endoscopic procedures are often employed for the surgical removal of kidney stones. Traditionally, large stones are removed by (standard) percutaneous nephrolithotomy (SPCNL). Although effective for the clearance of large stone burdens, SPCNL is associated with significant morbidity. Therefore, in an effort to reduce this morbidity, while preserving efficacy, mini-PCNL (MPCNL) with a smaller tract size (<20 French) was developed. Several studies suggest that MPCNL has a comparable stone-free rate to SPCNL. However, the question of lower morbidity with MPCNL remains unanswered. In this review, we describe the equipment, indications, and efficacy of MPCNL with particular attention to its value over traditional minimally invasive stone removal techniques.

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References

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  1. Scales Jr CD, Smith AC, Hanley JM, Saigal CS. Urologic diseases in America P. prevalence of kidney stones in the United States. Eur Urol. 2012;62:160–5.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ordon M, Urbach D, Mamdani M, Saskin R, RJ DAH, Pace KT. The surgical management of kidney stone disease: a population based time series analysis. J Urol. 2014;192:1450–6.

    Article  PubMed  Google Scholar 

  3. Preminger GM, Assimos DG, Lingeman JE, et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol. 2005;173:1991–2000.

    Article  PubMed  Google Scholar 

  4. Turk C, Petrik A, Sarica K. EAU Guidelines on interventional treatment for urolithiasis. Eur Urol. 2015.

  5. de la Rosette J, Assimos D, Desai M, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol. 2011;25:11–7.

    Article  PubMed  Google Scholar 

  6. Yamaguchi A, Skolarikos A, Buchholz NP, et al. Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5,537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study. J Endourol. 2011;25:933–9.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  8. Wright AE, Somani BK, Rukin NJ. Proposition for new terminologies in PCNL: what does ‘ultra-mini-micro’ actually mean? Urolithiasis. 2014;42:539–40. This article comprehensively describes the hardware available for the currently available minimally-invasive percutaneous nephrolithotomy systems.

    Article  PubMed  Google Scholar 

  9. Ganpule AP, Bhattu AS, Desai M. PCNL in the twenty-first century: role of Microperc, Miniperc, and Ultraminiperc. World J Urol. 2015;33(2):235–40.

    Article  PubMed  Google Scholar 

  10. Zeng G, Wan S, Zhao Z, et al. Super-mini percutaneous nephrolithotomy (SMP): a new concept in technique and instrumentation. BJU Int. 2015. doi:10.1111/bju.13242.

    PubMed  Google Scholar 

  11. Cheng F, Yu W, Zhang X, Yang S, Xia Y, Ruan Y. Minimally invasive tract in percutaneous nephrolithotomy for renal stones. J Endourol. 2010;24:1579–82.

    Article  PubMed  Google Scholar 

  12. Mishra S, Sharma R, Garg C, Kurien A, Sabnis R, Desai M. Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int. 2011;108(6):896–9. discussion899–900.

    PubMed  Google Scholar 

  13. Knoll T, Wezel F, Michel MS, Honeck P, Wendt-Nordahl G. Do patients benefit from miniaturized tubeless percutaneous nephrolithotomy? A comparative prospective study. J Endourol. 2010;24(7):1075–9. This article is a contemporary meta-analysis comparing standard percutaneous nephrolithotomy to mini-percutaneous nephrolithotomy in terms of stone free rate, operative characteristics, complications, and patient reported outcomes. It should be considered the highest-level of available evidence demonstrating that standard percutaneous nephrolithotomy and mini-percutaneous nephrolithotomy have equivalent stone free rate.

    Article  PubMed  Google Scholar 

  14. Zhu W, Liu Y, Liu L, Lei M, Yuan J, Wan SP. Minimally invasive versus standard percutaneous nephrolithotomy: a meta-analysis. Urolithiasis. 2015;43(6):563–70.

    Article  PubMed  Google Scholar 

  15. Matlaga BR, Hodges SJ, Shah OD, Passmore L, Hart LJ, Assimos DG. Percutaneous nephrostolithotomy: predictors of length of stay. J Urol. 2004;172:1351–4.

    Article  PubMed  Google Scholar 

  16. Kirac M, Bozkurt OF, Tunc L, Guneri C, Unsal A, Biri H. 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. 2013;41(3):241–6.

    Article  PubMed  Google Scholar 

  17. Sabnis RB, Jagtap J, Mishra S, Desai M. Treating renal calculi 1–2 cm in diameter with minipercutaneous or retrograde intrarenal surgery: a prospective comparative study. BJU Int. 2012;110((8 Pt B)):E346–9.

    Article  PubMed  Google Scholar 

  18. Lee JW, Park J, Lee SB, Son H, Cho SY, Jeong H. Mini-percutaneous nephrolithotomy vs retrograde intrarenal surgery for renal stones larger than 10 mm: a prospective randomized controlled trial. Urology. 2015;86:873–7.

    Article  PubMed  Google Scholar 

  19. Kruck S, Anastasiadis AG, Herrmann TR, et al. Minimally invasive percutaneous nephrolithotomy: an alternative to retrograde intrarenal surgery and shockwave lithotripsy. World J Urol. 2013;31(6):1555–61.

    Article  PubMed  Google Scholar 

  20. Kiremit MC, Guven S, Sarica K, et al. Contemporary management of medium-sized (10–20 mm) renal stones: a retrospective multicenter observational study. J Endourol. 2015;29(7):838–43.

    Article  PubMed  Google Scholar 

  21. Kumar A, Kumar N, Vasudeva P, Kumar Jha S, Kumar R, Singh H. A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience. J Urol. 2015;193(1):160–4.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Sasha C. Druskin & Justin B. Ziemba

  2. Johns Hopkins School of Medicine, Brady Urological Institute, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Justin B. Ziemba

Authors
  1. Sasha C. Druskin
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  2. Justin B. Ziemba
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Correspondence to Justin B. Ziemba.

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Sasha C. Druskin and Justin B. Ziemba each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Minimally Invasive Surgery

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Druskin, S.C., Ziemba, J.B. Minimally Invasive (“Mini”) Percutaneous Nephrolithotomy: Classification, Indications, and Outcomes. Curr Urol Rep 17, 30 (2016). https://doi.org/10.1007/s11934-016-0591-5

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  • DOI: https://doi.org/10.1007/s11934-016-0591-5

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