CC BY 4.0 · Surg J (N Y) 2020; 06(01): e19-e23
DOI: 10.1055/s-0040-1701225
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Mini PCNL Over Standard PCNL: What Makes it Better?

1  Department of Surgery, Nepal Army Institute of Health Sciences, Kathmandu, Nepal
,
Vikram Niranjan
2  Health Research Institute/Graduate Entry Medical School, University of Limerick, Limerick, Ireland
› Author Affiliations
Further Information

Publication History

29 June 2019

04 November 2019

Publication Date:
12 February 2020 (online)

  

Abstract

The incidence of small- and medium-size renal stones is rising. Stone clearance, bleeding, urine leak, and infectious complications are major concerns for urologists. They can choose the best technique from a list of armamentarium available. Minimally invasive approach like percutaneous nephrolithotomy (PCNL) has significantly influenced renal stone management since 1976. Miniaturization of the instruments innovate more effective and safer alternatives for urolithasis management. The outcome of mini-PCNL is explored and compared with standard PCNL in this review. Original research articles were reviewed using a systematic approach (keyword electronic database search). Duplicates were excluded in each step and 19 original articles out of 156 hits were analyzed. Mini-PCNL has significantly less bleeding complications and hospital stay. There were no significant difference in stone free rate between mini-PCNL and standard PCNL. The stone-free rate and complications rates were less dependent on the technique of puncture, tract dilatation, and energy used to fragment stones. The total operative time became slightly longer in mini-PCNL attributed to the sheath size and stone fragments retrieval. We found that mini-PCNL is as effective as standard PCNL with fewer complications. Stone burden is the key factor responsible for overall stone-free rate. However, the recommendation is limited by quality of study and the sample sizes.

Declaration

All contributing authors declare no conflicts of interest.