Is supermini‐percutaneous nephrolithotomy a new way forward?

Alken, P.

doi:10.1111/bju.14969

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…SFRs were from 60% to 90% when PCNL was miniaturized using ultra-mini PCNL (UMP), mini-perc, and micro-perc. Compared to previous minimally invasive PCNL investigations, the SMP group had a higher SFR [3,18,21]. Negative pressure suction is used to remove stone fragments during the SMP treatment, with the objective of leaving the patient stone-free at the end of the surgery [22,23].…”

Section: Discussionmentioning

confidence: 97%

“…Peter Alken, one of the founding fathers of PCNL, believes that the growing interest in PCNL is due to various factors. He finds that the SMP system has solved the shortcomings of standard mini-PCNL systems, such as effective stone removal, sufficient irrigation, and increased endoscopic vision [21]. He concluded that "based on my more than 40 years of experience with percutaneous stone removal and intense knowledge of the changes that were introduced I think it is justified to state the SMP technique is the most significant progress in this field, and it will likely become the dominant method for percutaneous stone management in the future."…”

Section: Discussionmentioning

confidence: 99%

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Super-Mini Percutaneous Nephrolithotomy for Nephrolithiasis: A Systematic Review and Meta-Analysis

Zeid¹,

Sayedin²,

Sridharan³

et al. 2022

Cureus

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We aimed to conduct a systematic review and meta-analysis to summarize the current evidence regarding the role of super-mini percutaneous nephrolithotomy (SMP), which refers to a 7-Fr nephroscope placed through a tract sized 10-14 Fr, in treating renal stones and compare its outcomes with the standard minipercutaneous nephrolithotomy (PCNL) techniques.A systematic literature search was conducted on the Medline database via PubMed and SCOPUS until May 2022 to retrieve the relevant studies. The titles and abstracts of unique records were screened for eligibility, followed by the full-text screening of potentially eligible abstracts. Data extraction was performed by two independent reviewers. The risk of bias assessment was conducted based on the study design. Open Meta (Analyst) and Review Manager 5.4 were used to perform all analyses. A total of 14 studies (n = 4,323 patients) were included, with two randomized controlled trials, one single-arm trial, and 11 cohort studies.The stone-free rate (SFR) of SMP was 91.4%. The pooled analysis showed no significant difference between SFR in mini-PCNL (mean difference (MD) = 1.03, 95% confidence interval (CI) = (0.99, 1.06), p = 0.12) and flexible ureteroscopy (MD = 0.84, 95% CI = (0.4, 1.76), p = 0.65]. On the other hand, SMP had a better SFR rate when compared with retrograde intrarenal surgery (MD = 1.3, 95% CI = (1.01, 1.66), p = 0.04). The pooled mean operative time of SMP was 49.44 minutes (95% CI = (41, 57.88), p < 0.001), which was longer than mini-PCNL (MD = 1.92, p < 0.001) and shorter than ureteroscopy (MD = -17.17, p < 0.00001). In the SMP group, the postoperative complications included fever (>38°C), pain, and hematuria, with an incidence of 7.6%, 2.3%, and 3.4%, respectively. The mean length of hospital stay after SMP was 2.4 days (95% CI = (2.17, 2.7), p < 0.001).The current evidence suggests that SMP is a safe and effective technique in the management of renal stones in both children and adults.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Super-Mini Percutaneous Nephrolithotomy for Nephrolithiasis: A Systematic Review and Meta-Analysis

Zeid¹,

Sayedin²,

Sridharan³

et al. 2022

Cureus

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“…In selected pediatric patients, the SMP technique could achieve better stone-free rate following single session, less need for auxiliary procedures, and lower complication rate [ 24 ]. Therefore, the suctioning technique in mini-PCNL presents significant advancements and can potentially become the dominant method for percutaneous stone management in the future [ 25 ].…”

Section: New Progress In Stone Removal Strategy—suction In Mini-pcnlmentioning

confidence: 99%

Miniaturization in percutaneous nephrolithotomy: What is new?

Zhu

Huang

Zeng

2023

Asian Journal of Urology

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Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study

et al. 2021

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Objective To compare the effectiveness and safety of Super-Mini PCNL (SMP) and Retrograde Intrarenal Surgery (RIRS) in the management of renal calculi ≤ 2 cm. Patients and methods A prospective, inter-institutional, observational study of patients presenting with renal calculi ≤ 2 cm. Patients underwent either SMP (Group 1) or RIRS (Group 2) and were performed by 2 experienced high-volume surgeons. Results Between September 2018 and April 2019, 593 patients underwent PCNL and 239 patients had RIRS in two tertiary centers. Among them, 149 patients were included for the final analysis after propensity-score matching out of which 75 patients underwent SMP in one center and 74 patients underwent RIRS in the other. The stone-free rate (SFR) was statistically significantly higher in Group 1 on POD-1 (98.66% vs. 89.19%; p = 0.015), and was still higher in Group 1 on POD-30 (98.66% vs. 93.24%, p = 0.092) SFR on both POD-1 and POD-30 for lower pole calculi was higher in Group 1 (100 vs. 82.61%, p = 0.047 and 100 vs 92.61% p = 0.171). The mean (SD) operative time was significantly shorter in Group 1 at 36.43 min (14.07) vs 51.15 (17.95) mins (p < 0.0001). The mean hemoglobin drop was significantly less in Group 1 (0.31 vs 0.53 gm%; p = 0.020). There were more Clavien–Dindo complications in Group 2 (p = 0.021). The mean VAS pain score was significantly less in Group 2 at 6 and 12 h postoperatively (2.52 vs 3.67, 1.85 vs 2.40, respectively: p < 0.0001), whereas the mean VAS pain score was significantly less in Group 1 at 24 h postoperatively (0.31 vs 1.01, p < 0.0001). The mean hospital stay was significantly shorter in Group 1 (28.37 vs 45.70 h; p < 0.0001). Conclusion SMP has significantly lower operative times, complication rates, shorter hospital stay, with higher stone-free rates compared to RIRS. SMP is associated with more early post-operative pain though.

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Is supermini‐percutaneous nephrolithotomy a new way forward?

Cited by 6 publications

References 9 publications

Super-Mini Percutaneous Nephrolithotomy for Nephrolithiasis: A Systematic Review and Meta-Analysis

Super-Mini Percutaneous Nephrolithotomy for Nephrolithiasis: A Systematic Review and Meta-Analysis

Miniaturization in percutaneous nephrolithotomy: What is new?

Super-mini percutaneous nephrolithotomy (SMP) vs retrograde intrarenal surgery (RIRS) in the management of renal calculi ≤ 2 cm: a propensity matched study

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