Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study
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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.
KeywordsMini-percutaneous nephrolithotomy Mini-PNL Miniperc Percutaneous nephrolithotomy Renal stones
Plain abdominal radiography
Non-contrast computed tomography scan
Stone free rate
Standard percutaneous nephrolithotomy
Extracorporeal shockwave lithotripsy
ElSheemy: Protocol/project development, data collection and management, data analysis, manuscript writing/editing. Elmarakbi: Protocol/project development, data collection and management. Hytham: Protocol/project development, data collection. Hamdy Ibrahim: Protocol/project development, data collection. Khadgi: Protocol/project development, data collection and management. Al-Kandari: Protocol/project development, data collection and management.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest. No funding source or industrial links and affiliations.
All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethical committee.
Informed consent was obtained from all the individual participants included in the study.
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