Comparative Study in the Treatment of Renal Stone Less than 2 cm Between Mini-perc and Standard PCNL in Erbil/Iraq
DOI:
https://doi.org/10.56056/amj.2025.384Keywords:
Kidney stone, Lithotripsy, Mini- percutaneous nephrolithotomy, Standard-percutaneous nephrolithotomyAbstract
Background and objectives: The management of nephrolithiasis has undergone substantial transformation with the introduction of minimally invasive endourological techniques. The objective of this research is to assess and compare the effectiveness of the two types of treatments of kidney stones mini-percutaneous nephrolithotomy versus conventional percutaneous nephrolithotomy.
Methods: A randomized comparison trial that included 150 patients diagnosed with renal stones from January 2022 to January 2024. Patients who were admitted to the urology department at Rizgary teaching hospital, Zheen international hospital and Zanko hospital were systematically assigned, through a random process, into 2 separate groups: A) mini-percutaneous nephrolithotomy group, or B) standard percutaneous nephrolithotomy. Parameters such as operative time, post operative hemoglobin level, complications, duration of hospitalization and residual stone were compared.
Results: The mean pre-operative hemoglobin was 13.5 ± 1.03 g/dl in patients who underwent standard Percutaneous, and 13.7 ± 0.65 g/dl in those who underwent mini-percutaneous nephrolithotomy (p>0.05). However, there was a statistically significant difference between mini-percutaneous nephrolithotomy post-operative hemoglobin (12.9 ± 0.79 g/dl) and standard percutaneous nephrolithotomy post operative hemoglobin (11.7 ± 2.5 g/dl) (p<0.05). There was no statistically significant difference in operative time between Group A and Group B. However, the rate of residual stone was significantly higher in standard percutaneous nephrolithotomy vs. mini-percutaneous nephrolithotomy (p<0.05).
Conclusions: Mini-percutaneous nephrolithotomy demonstrates enhanced efficacy in handling renal calculi, delivering a higher rate of stone clearance compared to Standard percutaneous nephrolithotomy.
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References
1. Li M, Zheng H, Zang Z, Lin S, Fang Y. Minimally invasive percutaneous nephrolithotomy compared with retrograde intrarenal surgery: a meta-analysis. Biomed Res. 2018;29(8):1558-1566.
2. Arslan B, Akbulut MF, Onuk O, Küçüktopçu O, Çilesiz NC, Ozkan A, et al. A comparison of Amplatz dilators and metal dilators for tract dilatation in mini-percutaneous nephrolithotomy. Int Urol Nephrol. 2017;49(04):581–585.
3. Romero V, Akpinar H, Assimos DG. Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol. 2010;12(2-3): e86–e96.
4. Ganpule AP, Bhattu AS, Desai M. PCNL in the twenty-first century: role of Microperc, Miniperc, and Ultraminiperc. World J Urol. 2015;33(2):235–240.
5. Türk C, Pet?ík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69(3):475-482. doi: 10.1016/j.eururo.2015.07.041.
6. Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, et al. Surgical management of stones: American Urological Association/Endourological Society Guideline, part I. J Urol. 2016;196(04):1153–1160.
7. Wright A, Rukin N, Smith D, De la Rosette J, Somani BK. 'Mini, ultra, micro' - nomenclature and cost of these new minimally invasive percutaneous nephrolithotomy (PCNL) techniques. Ther Adv Urol. 2016;8(02):142–146.
8. El-Nahas AR, Eraky I, Shokeir AA, Shoma AM, El-Assmy AM, El-Tabey NA, et al. Percutaneous nephrolithotomy for treating staghorn stones: 10 years of experience of a tertiary-care centre. Arab J Urol. 2012; 10:324–329.
9. Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. 2004; 18:715-722.
10. Kandemir E, Savun M, Sezer A, Erbin A, Akbulut MF, Sar?lar Ö. Comparison of Miniaturized Percutaneous Nephrolithotomy and Standard Percutaneous Nephrolithotomy in Secondary Patients: A Randomized Prospective Study. J Endourol. 2020; 34:26-32.
11. Sakr A, Salem E, Kamel M, Desoky E, Ragab A, Omran M, et al. Minimally invasive percutaneous nephrolithotomy vs standard PCNL for management of renal stones in the flank-free modified supine position: a single-center experience. Urolithiasis. 2017;45(6):585–589.
12. 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):1075–1079.
13. Song L, Chen Z, Liu T, Zhong J, Qin W, Guo S, et al. The application of a patented system to minimally invasive percutaneous nephrolithotomy. J Endourol. 2011;25(8):1281–1286.
14. Refaat HM, Hassan M, Salem T, Zaza M. Mini-percutaneous nephrolithotomy versus Standard percutaneous nephrolithotomy: outcome and complications. Afr J Urol. 2023; 29:31. doi.org/10.1186/s12301-023-00361-7/
15. Abdelhafez MF, Wendt-Nordahl G, Kruck S, Mager R, Stenzl A, Knoll T, et al. Minimally invasive versus conventional large-bore percutaneous nephrolithotomy in the treatment of large-sized renal calculi: Surgeon's preference. Scand J Urol. 2016;50(3):212-215. doi: 10.3109/21681805.2016.1155078/
16. Jiang H, Yu Z, Chen L, Wang T, Liu Z, Liu J, et al. Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis. Biomed Res Int. 2017; 2017:2035851. doi: 10.1155/2017/2035851/
17. 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(10):1579–1582.
18. Zeng G, Cai C, Duan X, Xu X, Mao H, Li X, et al. Mini percutaneous nephrolithotomy is a noninferior modality to standard percutaneous nephrolithotomy for the management of 20–40 mm renal calculi: a multicenter randomized controlled trial. Eur Urol. 2021;79(1):114–121.
19 ElSheemy MS, Elmarakbi AA, Hytham M, Ibrahim H, Khadgi S, Al-Kandari AM. Mini vs. standard percutaneous nephrolithotomy for renal stones: a comparative study. Urolithiasis. 2019;47(2):207–214.
20. Deng J, Li J, Wang L, Hong Y, Zheng L, Hu J. Standard versus mini-percutaneous nephrolithotomy for renal stones: a meta-analysis. Scand J Surg. 2021;110(3):301-311. doi: 10.1177/1457496920920474/
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Copyright (c) 2025 Bashdar Aziz Hussain, Nihad Rifaat Jawad, Akram Muhamed Mahmud
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