Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

Abstract

Background: The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results: Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18-68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm 2 (mean ± SD 172.48 ± 69.54 mm 2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion: Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

Miniaturizing the approach to upper tract renal calculi: Is smaller always better? A narrative review

“…From this sheath, an 8/9.8-Fr rigid ureteroscope was placed, and a holmium:YAG laser or pneumatic lithotripter was used to fragment the calculi. [14] In a single-center study performed by Salih et al [15] in 2019, the safety and efficacy of MIPNL in the treatment of renal calculi ≤20 mm was evaluated. In this cohort of 67 patients who underwent MIPNL, 55 (82.0%) patients were stone free after MIPNL, the operative time ranged from 40 to 190 minutes (mean, 74.58 ± 30.34 minutes), and the hospital stays ranged from 2 to 7 days (mean, 3.34 ± 1.62 days).…”

Outcomes of (chinese) mini-percutaneous nephrolithotomy for renal stones: a prospective trial

“…With Chinese Mini-PCNL technique, a ureteroscope is used through a percutaneous approach. (11) This study aimed to assess the postoperative outcomes of chinese mini-PCNL in adult patients with renal calculi less than 3 cm in diameter.…”