Search our Database of Scientific Publications and Authors

I’m looking for a
    [Evolution from Percutaneous nephrolithotomy to Mini-PCNL in supine position on the treatment of complex renal calculi: feasibility study.]
    Arch Esp Urol 2017 Jun;70(5):542-549
    Servicio de Urología. Hospital Universitario de Getafe. Madrid. España.
    Objectives: Mini-PCNL is a potentially less invasive technique than standard percutaneous nephrolithotomy (PCNL). We present our experience and results comparing both approaches in large burden complex renal calculi.

    Methods: Prospective non randomized study comparing PCNL (24/26F nephroscope; Group A) and Mini-PCNL (15/18F; Group B) perioperative and postoperative results, in 40 (20 each group) consecutive patients between 2013 and 2014. We analyze demographic data, hemoglobin drop, urine culture, stone characteristics, operative time, puncture, number and size of the tract, disintegration energy sources, nephrostomy placement, hospital stay, stone free rate and Clavien-Dindo complications.

    Results: Evolution has shown growth for Mini-PNL, with the last 17 consecutive cases performed by this approach. No preoperative differences in laterality, age, gender or ASA were found; but there were differences in BMI (median Group A: 26.35 kg/m2; Median Group B: 33.05 kg/m2, p = 0.008). Median calculi surface area (SA = length × width × π × 0.25) was higher for mini-PNL (6.69 cm2 vs 14.14; p=0.003). The operative time was longer for mini-PNL (120 vs 162.5 min, p = 0.03). Only one case (5%) required transfusion in NLP 24/26F. Mini-PCNL was associated with tubeless technique (55%) (p = 0.022), which explains lower 24 h postoperative pain, after surgery, measured by VAS (p =0.0004). The hospital stay was equivalent (median: 2 days; p=0.8). Both techniques showed efficacy (SFR at 3 months 80%). There were no statistically significant differences between the number and severity of complications between groups (Group A: 15%, 66.7% Clavien II, Group B: 15%; 66.7% Clavien II, p = 1).

    Conclusions: Mini-NLP can manage kidney stones and even large staghorn calculi without nephrostomy in a high percentage of patients. The technical evolution towards a small caliber approach maintains the effectiveness of the procedure without impacting its safety, with benefits perceived by patients such as less postoperative pain.

    Similar Publications

    Outcomes following 'mini' percutaneous nephrolithotomy for renal calculi in children. A single-centre study.
    J Pediatr Urol 2015 Jun 7;11(3):120.e1-5. Epub 2015 Mar 7.
    Department of Paediatric Urology, Sheffield Children's Hospital, Western Bank, Sheffield, S10 2TH, UK. Electronic address:
    Introduction: This retrospective review was undertaken to identify the postoperative outcomes of children undergoing 'mini' percutaneous nephrolithotomy (MPCNL) at a single institution.

    Objective: Outcomes measured included: percentage of stone clearance, postoperative analgesia requirements, the need for intraoperative or postoperative blood transfusion, length of stay and morbidity.

    Study Design: A total of 46 patients were reviewed over a two-and-a-half-year period; the mean age was 7. Read More
    Minimally invasive tract in percutaneous nephrolithotomy for renal stones.
    J Endourol 2010 Oct;24(10):1579-82
    Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
    Aim: The aim of this study was to assess the efficacy, safety, and morbidity of minimally invasive tract in percutaneous nephrolithotomy (Mini-PCNL) for renal stones in comparison with the standard PCNL.

    Patients And Methods: In a randomized trial, 69 patients (72 renal units) undergoing Mini-PCNL (group 1) from May 2004 to December 2007 were compared with a similar group of 111 (115 renal units) patients undergoing standard PCNL (group 2). Patients who needed more than one percutaneous tract or who had simultaneously undergone the two techniques on the same renal unit were excluded from the study group. Read More
    Supine pediatric percutaneous nephrolithotomy (PCNL).
    J Pediatr Urol 2015 Apr 4;11(2):78.e1-5. Epub 2015 Mar 4.
    Department of Urology, Sohag University, Egypt.
    Introduction/background: Many authors reported their experience with supine PCNL in adult population comparing the outcome with prone PCNL and they found that the stone free rate and the operative time were in favor of prone PCNL with a lower patient morbidity among patients with supine PCNL. This encouraged us to perform supine PCNL in pediatric population.

    An Objective: In this study we evaluated the safety and efficacy of supine PCNL in pediatric population. Read More
    Endoscopic combined intrarenal surgery for large calculi: simultaneous use of flexible ureteroscopy and mini-percutaneous nephrolithotomy overcomes the disadvantageous of percutaneous nephrolithotomy monotherapy.
    J Endourol 2014 Jan 24;28(1):28-33. Epub 2013 Oct 24.
    1 Department of Nephrourology, Nagoya City University Graduate School of Medical Sciences , Nagoya, Japan .
    Background And Purpose: Percutaneous nephrolithotomy (PCNL) is considered the standard procedure for the removal of large renal calculi. The development of the "minimally invasive PCNL" (mini-PCNL) has reduced the complications of the surgery; it also appears to be associated with less morbidity than the conventional PCNL (con-PCNL). This study aimed at evaluating the efficacy of endoscopic intrarenal surgery, using the prone-split leg position, using flexible ureteroscopy and mini-PCNL (mini- endoscopic combined intrarenal surgery [ECIRS]) by retrospectively comparing this technique with mini-PCNL and con-PCNL. Read More