Introduction: The aim of this study is to evaluate the outcomes of tubeless mini- percutaneous nephrolithotomy (PCNL) for the treatment of large (>20 mm) renal stones.
Patients And Methods: This study included consecutive patients who underwent single-session tubeless mini-PCNL (tract size 16-20 F) for large (>20 mm) renal stones. Stone-free status meant complete clearance or residual fragments <4 mm. Complications were recorded and classified according to modified Clavien-Dindo classifications. Risk variables for significant residuals were determined with univariate (Chi-square and -test) and multivariate logistic regression analyses.
Results: Between July 2015 and November 2018, 225 patients were included. The mean age was 42.9 years; the mean stone size was 30.2 ± 9.6 mm and 75% of patients were males. A single renal stone was present in 54 patients (24%), multiple stones in 108 (48%), and staghorn stones in 63 (28%). The stone-free rate was 87.6%. The complication rate was 8.4% (Grade I-II in 7.5%, III in 0.9%). Three patients (1.3%) required blood transfusion. Independent risk factor for significant residual fragments was the presence of stones in multiple sites inside the pelvicalyceal system (relative risk: 13.44, 95% confidence interval: 1.78-101.43, = 0.012).
Conclusions: Mini-PCNL is an effective and safe treatment option for patients with large renal stones (>20 mm). Stones located in multiple sites is the only predictor of significant residual stones.
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http://dx.doi.org/10.4103/iju.IJU_271_20 | DOI Listing |
Mymensingh Med J
January 2025
Dr Md Saidur Rahaman, Registrar, Department of Urology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large kidney stones. Recent advancements in endoscopic technology and operative techniques have significantly increased the success rate of PCNL while reducing associated complications and morbidity. A key development contributing to this progress is the introduction of various new lithotripter techniques, which facilitate rapid stone fragmentation and clearance.
View Article and Find Full Text PDFUrolithiasis
December 2024
Pediatric Urology Clinic, Konya City Hospital, Karatay, Konya, 42020, Turkey.
The flexible and navigable suction ureteral access sheath (FANS-UAS) has increasingly been recognized as a potential game changer for retrograde intrarenal surgery (RIRS). While this innovative technology has demonstrated promising results in adult populations, there is a notable lack of evidence regarding its application in pediatric cases, particularly in comparison to conventional ureteral access sheaths (CUAS). This study aimed to perform a comparative analysis of pediatric kidney stone cases treated with RIRS using FANS-UAS and CUAS.
View Article and Find Full Text PDFClin Transplant
January 2025
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Purpose: This study aimed to assess whether kidney stone burden and risk factors at the time of kidney donor evaluation were associated with a symptomatic stone event post-donor evaluation.
Methods: We identified adults evaluated at Mayo Clinic (two sites) (2000-2011) for living kidney donation and had either a personal history or radiological evidence of kidney stone disease. We analyzed demographics, stone risk factors, stone number/size, and the committee's donation decision and reasons.
BMC Urol
December 2024
Department of Urology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Background: Managing lower pole renal stones presents clinical challenges influenced by various factors such as stone size, location, and density. This study aims to assess the efficacy, safety, and stone-free rates of Flexible Ureteroscopy (FURS), Extracorporeal Shock Wave Lithotripsy (ESWL), and Mini Percutaneous Nephrolithotomy (Mini PCNL) for treating lower pole renal hard stones (< 2 cm).
Methods: A prospective single-centre comparative study was conducted on 414 adult patients with primary lower pole renal hard stones.
Med J Armed Forces India
December 2024
CSO Medical, Andaman & Nicobar Command HQ, India.
Background: Lower calyceal anatomy makes the stone clearance a difficult task across all treatment formats. Improvement in optics and miniaturization of instruments have offered an effective and safer alternative to percutaneous nephrolithotomy (PCNL). The study was conducted to compare the efficacy and complications associated with mini-PCNL vs standard-PCNL.
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