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Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study.
Urolithiasis 2019; 47(2):207-214U

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.

Authors+Show Affiliations

Urology department, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt. mohammedshemy@yahoo.com.Urology Department, Bani Swaif University, Bani Swaif, Egypt.Urology department, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt.Urology Department, Fayoum University, Fayoum, Egypt.Vayodah and Venus International Hospitals, Kathmandu, Nepal.Urology Department, Kuwait University, Kuwait City, Kuwait.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29549382

Citation

ElSheemy, Mohammed S., et al. "Mini Vs Standard Percutaneous Nephrolithotomy for Renal Stones: a Comparative Study." Urolithiasis, vol. 47, no. 2, 2019, pp. 207-214.
ElSheemy MS, Elmarakbi AA, Hytham M, et al. Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study. Urolithiasis. 2019;47(2):207-214.
ElSheemy, M. S., Elmarakbi, A. A., Hytham, M., Ibrahim, H., Khadgi, S., & Al-Kandari, A. M. (2019). Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study. Urolithiasis, 47(2), pp. 207-214. doi:10.1007/s00240-018-1055-9.
ElSheemy MS, et al. Mini Vs Standard Percutaneous Nephrolithotomy for Renal Stones: a Comparative Study. Urolithiasis. 2019;47(2):207-214. PubMed PMID: 29549382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study. AU - ElSheemy,Mohammed S, AU - Elmarakbi,Akram A, AU - Hytham,Mohammed, AU - Ibrahim,Hamdy, AU - Khadgi,Sanjay, AU - Al-Kandari,Ahmed M, Y1 - 2018/03/16/ PY - 2018/01/22/received PY - 2018/03/05/accepted PY - 2018/3/20/pubmed PY - 2019/4/17/medline PY - 2018/3/18/entrez KW - Mini-PNL KW - Mini-percutaneous nephrolithotomy KW - Miniperc KW - Percutaneous nephrolithotomy KW - Renal stones SP - 207 EP - 214 JF - Urolithiasis JO - Urolithiasis VL - 47 IS - 2 N2 - 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. SN - 2194-7236 UR - https://www.unboundmedicine.com/medline/citation/29549382/Mini_vs_standard_percutaneous_nephrolithotomy_for_renal_stones:_a_comparative_study_ L2 - https://dx.doi.org/10.1007/s00240-018-1055-9 DB - PRIME DP - Unbound Medicine ER -