Trifecta rate and its predictor variables according to calibres in percutaneous nephrolithotomy

Abstract

Objective: The aim of this study is to determine and compare the number of patients who met the trifecta criteria using standard, Mini-15Fr and Ultra-Mini percutaneous nephrolithotomy (PCNL). Material and methods: Retrospective study of PCNL in Galdakao-modified supine Valdivia position with standard, Mini-15Fr and Ultra-Mini PCNL. Results: A total of 164 consecutive patients were analysed. Forty-six patients underwent standard PCNL (29.6%), 58 patients Mini-15Fr (34.4%) and 61 patients Ultra-Mini (36%). The Ultra-Mini had the lowest rate of complications (15%) followed by standard PCNL (18.6%) and Mini-15Fr (20.7%). There was no difference in stone-free rate (SFR). The trifecta rate was slightly higher in the Ultra-Mini at 65%, followed by the Mini-15Fr group (55%) and PCNL standard with 50% ( p = 0.280). Univariate logistic regression found that lower surgical time (odds ratio (OR) = 1.01), tubeless technique (OR = 2.87) and shorter hospitalization (OR = 1.72) time were factors to favourable accomplishment of trifecta. In multivariate logistic regression, shorter hospitalization was established as independent predictor for achievement of trifecta (OR = 1.74). Conclusions: The miniaturized calibres in our study had a similar SFR and complications compared to the standard calibre in lithiasis smaller than 5 cm in diameter. The tubeless rate was higher and mean hospitalization was lower in the Mini-15Fr and Ultra-Mini. Tubeless technique and shorter hospitalization were predictors of trifecta. Level of evidence: 2c