MINI-PERCUTANEOUS NEPHROLITHOTOMY (MINI-PCNL) VERSUS STANDARD PCNL (S-PCNL) FOR RENAL STONE OF MORE THAN 2CM IN DUHOK GOVERNORATE
Background: This research aimed to make a comparison between the mini-percutaneous nephrolithotomy (Mini-PCNL) versus standard (S-PCNL) techniques for kidney stones of more than 20mm in regards of their rates of success and complications in candidates with urolithiasisin Azadi teaching hospital and Vajeen private hospital in Duhok governorate.
Patients and procedures: This clinical research was performed during April 2018-April 2019. Fifty participants with renal stones larger than 2cm were assigned into two groups regarding their treatment options by PCNL, either Mini-PCNL by using nephroscope 18 Fr through 24 Frsheath, or by the S-PCNL by using 24 Fr nephroscope through 30Fr sheath. The stones were crushed with pneumatic lithotripsy.
Results: Our data have shown that there was no difference in the stone free rates in both groups but statistically significant differences in postoperative haematocrit level, operative time, analgesic requirement, hospital stay, and complication rate among the patients applying Fisher’s exact tests, Chi square or Student-t test as needed. In addition to the logistic regression analysis. No significant differences were seen in patient’s characteristic between the two groups with.
Conclusions: Mini-PCNL has similar efficacy and SFR with lower complication rates in comparison with S-PCNL.
2. Bahari, M., M. Fazli, A. Firouzian, S.A. Hashemi, and N. Moosanejad. "Comparison of totally tubeless percutaneous nephrolithotomy and Spercutaneous nephrolithotomy for kidney stones: a randomized, clinical trial". Brazilian Journal of Medical and Biological Research. 2016; 49 (4).
3. El Sheemy, Mohammed S., Akram A. Elmarakbi, Mohammed Hytham, Hamdy Ibrahim, Sanjay Khadgi, and Ahmed M. Al-Kandari.."Mini vs Spercutaneousn ephrolithotomy for renal stones: a comparative study". Urolithiasis.2019; 47 (2): 207-214.
4. Jackman SV, Hedican SP, Peters CA, DocimoSG.Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology. 1998;52(4):697–701.
5. Lahme S, Bichler KH, Strohmaier WL, Gotz T . Minimally invasive PCNL in patients with renal pelvic and calyceal stones. EurUrol. 2001; 40(6): 619–624.
6. Sakr A, Salem E, Kamel M, Desoky E, Ragab A, Omran M, Fawzi A, Shahin A .Minimally invasive percutaneous nephrolithotomy vs standard PCNL for management of renal stones in the flank-free modified supine position: single-centre experience. Urolithiasis. 2017; Feb 22.
7. Xu S, Shi H, Zhu J, Wang Y, Cao Y, Li K, Wang Y, Sun Z, XiaS . A prospective comparative study of haemodynamic, electrolyte, and metabolic changes during percutaneous nephrolithotomy and minimally invasive percutaneous nephrolithotomy. World J Urol. 2014; 32(5): 1275–1280.
8. Mishra S, Sharma R, Garg C, Kurien A, Sabnis R, Desai M . Prospective comparative study of miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int. 2011; 108(6):896–900.
9. Song L, Chen Z, Liu T, Zhong J, Qin W, Guo S, Peng Z, Hu M, Du C, Zhu L, Yao L, Yang Z, Huang J, Xie D . The application of a patented system to minimally invasive percutaneousUrolithiasis1 3nephrolithotomy. J Endourol. 2011; 25(8): 1281–1286.
10. Knoll T, Wezel F, Michel MS, Honeck P, Wendt-Nordahl G. Do patients benefit from miniaturized tubeless percutaneous nephrolithotomy? A comparative prospective study. J Endourol .2011; 24 (7): 1075–1079.
11. Zhong W, Zeng G, Wu W, Chen W, Wu K . Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res. 2011; 39(2): 117–122.
12. Srisubt A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS)
for kidney stones. Cochrane Database Syst Rev . 2009; 7 : CD007044.
13. Feng MI, Tamaddon K, Mikhail A, Kaptein JS, Bellman GC. Prospective randomized study of various techniques of percutaneous nephrolithotomy. Urology. 2001; 58: 345–50.
14. Desai MR, Kukreja RA, Desai MM et al. A prospective randomized comparison of type of nephrostomy drainage following percutaneous nephrostolithotomy: large bore versus small bore versus tubeless. J Urol. 2004; 172: 565–7.
15. Giusti G, Piccinelli A, TavernaG et al. Miniperc? No, thank you! EurUrol 2007; 51: 810–4; discussion 815. Epub .2006 Aug 11 16.
16. Bilen CY, Koçak B, Kitirci G, Ozkaya O, Sarikaya S. Percutaneous nephrolithotomy in children: lessons learned in 5 years at a single institution. J Urol. 2007; 177: 1867– 71.
17. Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW. The ‘mini-perc’ technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol. 1998; 16 : 371–4.
18. Yang SF, Lei M, Li X. Minimally invasive percutaneous nephrolithotomy for impacted upper ureteric calculi (a report of 71 cases). Chin J Mod Operative Surg. 2003; 4: 297–8.
19. Zhu W, Liu Y, Liu L, Lei M, Yuan J, Wan SP, Zeng G .Minimally invasive versus standard percutaneous nephrolithotomy:Urolithiasis. 2016;44 (5):421-6.