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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; discussion 899-900BI

Abstract

OBJECTIVE

• To evaluate the results of miniperc vis-à-vis standard PNL in the treatment of stones of 1-2 cm in size. Miniperc may represent a reasonable procedure in patients with nonbulky urolithiasis offering a similar outcome as standard percutaneous nephrolithotomy (PNL) with advantage of reduced morbidity.

PATIENTS AND METHODS

• 55 procedures including 27 miniperc and 28 standard PNL were performed for renal stones 1-2 cm in size. Pediatric patient, active urinary tract infection, renal malformation, uncorrected coagulopathy and morbid obesity patients were excluded from the study. • The parameters studied were demography, operative time, postoperative analgesic requirement, hemoglobin drop, complications and stone clearance.

RESULTS

• Mean tract size was 18.2 ± 2 F (15-20) and 26.8 ± 2 F (24-30), P value <0.0001 in the miniperc and standard PNL, respectively. Holmium LASER and pneumatic lithotripter were the main energy sources used in miniperc and standard PNL, respectively. • Miniperc operative time was longer than that of standard PNL (45.2 ± 12.6 vs 31 ± 16.6 min, P= 0.0008 respectively). • Conversely, there was an advantage of miniperc over standard PNL in terms of a significantly reduced hemoglobin drop (0.8 ± 0.9 vs 1.3 ± 0.4 gram%, P= 0.01), analgesic requirement (55.4 ± 50 vs 70.2 ± 52 mg tramadol, P= 0.29) and hospital stay (3.2 ± 0.8 vs 4.8 ± 0.6 days, P ≤ 0.001), respectively. • Intra- operative conversion of the procedure into a tubeless PNL was significantly more in the miniperc group (P ≤ 0.001). The miniperc and standard PNL group had clearance rates of 96% and 100%, respectively at 1 month follow up.

CONCLUSIONS

• This study demonstrated significant advantages of the miniperc procedure in terms of reduced bleeding leading to a tubeless procedure and reduced hospital stay. • The stone free rates and the complications were similar in either group.

Authors+Show Affiliations

Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21477212

Citation

Mishra, Shashikant, et al. "Prospective Comparative Study of Miniperc and Standard PNL for Treatment of 1 to 2 Cm Size Renal Stone." BJU International, vol. 108, no. 6, 2011, pp. 896-9; discussion 899-900.
Mishra S, Sharma R, Garg C, et al. 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; discussion 899-900.
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 International, 108(6), pp. 896-9; discussion 899-900. doi:10.1111/j.1464-410X.2010.09936.x.
Mishra S, et al. 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; discussion 899-900. PubMed PMID: 21477212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. AU - Mishra,Shashikant, AU - Sharma,Rajan, AU - Garg,Chandrapraksh, AU - Kurien,Abraham, AU - Sabnis,Ravindra, AU - Desai,Mahesh, Y1 - 2011/04/08/ PY - 2011/4/12/entrez PY - 2011/4/12/pubmed PY - 2011/10/21/medline SP - 896-9; discussion 899-900 JF - BJU international JO - BJU Int. VL - 108 IS - 6 N2 - OBJECTIVE: • To evaluate the results of miniperc vis-à-vis standard PNL in the treatment of stones of 1-2 cm in size. Miniperc may represent a reasonable procedure in patients with nonbulky urolithiasis offering a similar outcome as standard percutaneous nephrolithotomy (PNL) with advantage of reduced morbidity. PATIENTS AND METHODS: • 55 procedures including 27 miniperc and 28 standard PNL were performed for renal stones 1-2 cm in size. Pediatric patient, active urinary tract infection, renal malformation, uncorrected coagulopathy and morbid obesity patients were excluded from the study. • The parameters studied were demography, operative time, postoperative analgesic requirement, hemoglobin drop, complications and stone clearance. RESULTS: • Mean tract size was 18.2 ± 2 F (15-20) and 26.8 ± 2 F (24-30), P value <0.0001 in the miniperc and standard PNL, respectively. Holmium LASER and pneumatic lithotripter were the main energy sources used in miniperc and standard PNL, respectively. • Miniperc operative time was longer than that of standard PNL (45.2 ± 12.6 vs 31 ± 16.6 min, P= 0.0008 respectively). • Conversely, there was an advantage of miniperc over standard PNL in terms of a significantly reduced hemoglobin drop (0.8 ± 0.9 vs 1.3 ± 0.4 gram%, P= 0.01), analgesic requirement (55.4 ± 50 vs 70.2 ± 52 mg tramadol, P= 0.29) and hospital stay (3.2 ± 0.8 vs 4.8 ± 0.6 days, P ≤ 0.001), respectively. • Intra- operative conversion of the procedure into a tubeless PNL was significantly more in the miniperc group (P ≤ 0.001). The miniperc and standard PNL group had clearance rates of 96% and 100%, respectively at 1 month follow up. CONCLUSIONS: • This study demonstrated significant advantages of the miniperc procedure in terms of reduced bleeding leading to a tubeless procedure and reduced hospital stay. • The stone free rates and the complications were similar in either group. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/21477212/Prospective_comparative_study_of_miniperc_and_standard_PNL_for_treatment_of_1_to_2_cm_size_renal_stone_ L2 - https://doi.org/10.1111/j.1464-410X.2010.09936.x DB - PRIME DP - Unbound Medicine ER -