Mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of 10–20 mm lower pole renal stones: a systematic review and meta-analysis

Cabrera, Jose David; Manzo, Braulio Omar; Torres, José E.; Vicentini, Fábio Carvalho; Sánchez, H.; Rojas, Ernesto A; Lozada, Edgard

doi:10.1007/s00345-019-03043-8

Cited by 36 publications

(25 citation statements)

References 23 publications

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“…Most studies, including six metanalyses, agree on the superiority of mPCNL over fURS when it comes to nal success or stone-free rate [1,4,10,12,14,15,16,18,19,20,22,23]. This is unlike the results of the current study which show comparable nal success rates for both procedures (98.3% for mPCNL and 94.9% for fURS; P = 0.619).…”

Section: Discussioncontrasting

confidence: 61%

WITHDRAWN: Flexible Uretero-Renoscopy Versus Mini-Percutaneous Nephrolithotomy for Treatment of Renal Stones 2 Cm or Less; A Randomised, Comparative Study

Darwish

Abdel-Moniem

Ahmed

et al. 2022

Preprint

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Purpose: To compare the outcomes of treatment of renal stones of 2 cm or less with either fURS or mPCNL.Methods: This was a prospective, randomized, comparative study conducted between January 2019 and July 2021 at three tertiary care Urology centers. Inclusion criteria were adult patients with renal stone(s) ≤ 2cm with inappropriateness or failure of extracorporeal shock-wave lithotripsy. The two treatment groups were mPCNL and fURS. Mini-percutaneous nephrolithotomy was done in the prone position under fluoroscopic guidance using a 12-Fr., rigid Nephroscope with the track dilated up to 18 Fr. The study assessed two primary outcomes: (1) initial success rate, which meant absence of CSRF (> 2mm) at the level of KUB and ultrasound on the 1st post-operative day; (2) complications, which were reported according to the Modified Clavien-Dindo classification system. Secondary outcomes included final success rate, which meant absence of CSRF at the level of NCCT on the 90th post-operative day; operative time; auxiliary procedure and blood transfusion rates; haemoglobin drop; and hospital stay.Results: One hundred eighteen procedures were analysed (59 in each group). Initial success rate of mPCNL (93%) was significantly higher than fURS (70%). Complications occurred more frequently with mPCNL (44.1% versus 18.6%, respectively). Final success rate, operative time and hospital stay were comparable between the two groups.Conclusion: Mini-percutaneous nephrolithotomy is more effective than fURS as a rapid, single-step treatment for renal stones due to its higher first-day success rate and lower auxiliary procedure rate. However, it results in significantly higher morbidity than fURS.

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Section: Discussioncontrasting

confidence: 61%

WITHDRAWN: Flexible Uretero-Renoscopy Versus Mini-Percutaneous Nephrolithotomy for Treatment of Renal Stones 2 Cm or Less; A Randomised, Comparative Study

Darwish

Abdel-Moniem

Ahmed

et al. 2022

Preprint

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“…There was no significant difference regarding the pain intensity between both groups (P value 0.355). The mean hospital stay after surgery was 16.7 (4.772) hours for the RIRS groups and 38.2 (8.616) for the miniPCNL group, and the difference was a significant one between both groups (P value 0.0001) being less in the RIRS group [ 1 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Can mini PCNL achieve the same results as RIRS? The initial single center experience

Ghazala

Ahmed

Mohammed

2021

Annals of Medicine &Amp; Surgery

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Background Urolithiasis is a prevalent disease worldwide with high recurrence rate, minimally invasive interventions have largely replaced open ones, namely PCNL and RIRS. Miniaturization, optical improvements, and modern laser types made these procedures safe and effective in the management of single renal stones. Aim of the study : Is to compare the effectiveness of mini PCNL with RIRS in the treatment of single renal stone of ≤25 mm. Patients and methods This prospective study that included 60 patients with single renal stones of ≤25 mm and were treated by either mini PCNL (group A) or RIRS (group B). The study was performed during the period from October 2020 to April 2021. Results The mean operative time RIRS group was 43.6 ± 10.493, while for miniPCNL it was 36.6 ± 7.035 (P = 0.004). The stone free rate in RIRS and miniPCNL group was 70% and 90% respectively (P = 0.053). The need for JJ stent was higher in RIRS compared to miniPCNL group (70% vs. 40%) respectively (P = 0.02). The duration of hospital stay in miniPCNL was 38.2 h compared to 16.7 h for RIRS group (p = 0.0001). The rate of postoperative hemoglobin drop was higher in MiniPCNL compared to RIRS (P = 0.0001). There was no significant difference regarding complication rates between both groups. Conclusion Mini-PCNL FOR the treatment of renal stones sized ≤25 mm has high stone free rate, shorter operative time, less requirement for JJ stent and near similar post-operative pain and complications compared to RIRS.

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“…First, mPNL uses a smaller percutaneous catheter than sPNL, so the renal parenchyma is less damaged. On the other hand, although smaller renal tubules may hinder the fragmentation and removal of stones, research has shown that mPNL has an obvious advantage in managing renal calculi with diameters of 20–40 mm ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Mini-Percutaneous Nephrolithotomy With an Endoscopic Surgical Monitoring System for the Management of Renal Stones: A Retrospective Evaluation

et al. 2022

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PurposeTo compare the outcomes and postoperative quality of life of patients with renal calculi who underwent standard percutaneous nephrolithotomy (sPNL), mini-invasive percutaneous nephrolithotomy (mPNL) or mPNL with an endoscopic surgical monitoring system (ESMS) using a retrospective clinical trial.MethodsEighty-six adult patients with renal stones who were treated with sPNL were retrospectively compared to ninety-two patients who were treated with mPNL between July 2014 and December 2017. Next, further studies were retrospectively conducted using a matched paired method. The ninety-two patients treated with mPNL were divided into two groups based on whether the endoscopic surgical monitoring system (ESMS) was used (ESMS-mPNL vs. non-ESMS-mPNL). The ESMS used strain gauge transducers to measure the inflow and outflow of irrigation solution. Bleeding and fluid absorption during endoscopic surgery could be accurately calculated by computer program in ESMS.ResultsThe fluoroscopy time, complication rate, stone-free status and clinically insignificant residual fragment (CIRF) rate were not significantly different between the two groups (sPNL vs. mPNL). The mPNL group had a significantly longer operation time than the sPNL group, and the mPNL group exhibited a markedly reduced 12-h postoperative visual analogue pain scale (VAS) score, mean hospitalization time, and return to work time, had slightly reduced haemoglobin loss, and underwent more tubeless operations. Moreover, among the 92 patients who underwent mPNL, the operation time (P = 0.090), complication rate (P = 0.996), stone-free status (P = 0.731), CIRF rates (P = 0.125) and number of tubeless operations (P = 0.760) were not significantly different between the two subgroups (non-ESMS-mPNL vs. ESMS-mPNL); however, the patients in the ESMS-mPNL group had significantly longer operation times than those in the non-ESMS-mPNL subgroup, along with marked reductions in irrigation fluid absorption, blood loss, haemoglobin loss, 12 h postoperative VAS score, mean hospitalization time, and return to work time.ConclusionsmPNL is less painful than sPNL in patients undergoing treatment for 20–40 mm renal stones. Similar stone-free rates were achieved by the two procedures, but mPNL was superior to sPNL in terms of blood loss, discomfort, hospitalization time and return to work time. We think that ESMS-mPNL is less painful for patients and more efficacious than non-ESMS-mPNL, and ESMS-mPNL achieves a stone-free rate that is similar to non-ESMS-mPNL in patients receiving treatment for 20–40 mm kidney stones.

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Mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of 10–20 mm lower pole renal stones: a systematic review and meta-analysis

Cited by 36 publications

References 23 publications

WITHDRAWN: Flexible Uretero-Renoscopy Versus Mini-Percutaneous Nephrolithotomy for Treatment of Renal Stones 2 Cm or Less; A Randomised, Comparative Study

WITHDRAWN: Flexible Uretero-Renoscopy Versus Mini-Percutaneous Nephrolithotomy for Treatment of Renal Stones 2 Cm or Less; A Randomised, Comparative Study

Can mini PCNL achieve the same results as RIRS? The initial single center experience

Mini-Percutaneous Nephrolithotomy With an Endoscopic Surgical Monitoring System for the Management of Renal Stones: A Retrospective Evaluation

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