Comparison Between Mini PCNL and Standard PCNL in Management of Nephrolithiasis

Abstract

Introduction: The incidence of small and medium size renal stones is rising. Stone clearance, bleeding, urine leak and infectious complications are major concerns for urologist. Urologist chooses best technique from list of armamentarium available. Minimally invasive approach like Percutaneous Nephrolithotomy (PCNL) has significantly influenced the renal stone management since 1976. Miniaturisation of the instruments allow more effective and safer alternatives for urolithasis management.
 Methods: This is a retrospective study in which the outcome of mini PCNL (mPCNL) was compared with standard PCNL (sPCNL) in management of nephrolithiasis. 
 Result: There were no significant difference in stone free rate between mPCNL and sPCNL (96.2 ± 3.6% vs 95.3 ± 4.8%). The total operative time was longer in mPCNL (55.2 ± 19.0 minute vs 62 ± 21.0 minute) but the difference was not statistically significant.
 Conclusions: Mini PCNL is as effective as standard PCNL with fewer bleeding complications in management of medium sized nephrolithiasis.

Kidney stone management in the era of miniaturized percutaneous nephrolithotomy: does it improve safety? a prospective cohort study

“…Nevertheless, several factors affect blood loss during PCNL such as the dilation method, number of tracts, operative time, and stone characteristics. In a retrospective study comparing sPCNL( n =95) and mPCNL( n =79), Bhandari et al 13 reported a significantly higher haemoglobin drop in the sPCNL group (3.3±0.5 vs. 1.3±0.8 g/dl). In another similar study, Thakur et al 14 found that mPCNL had significantly less haemoglobin drop (1.61±0.9 vs. 1.21±0.7 g/dl) but transfusion rate was similar in both groups.…”