Complications of mini-percutaneous nephrolithotomy and standard percutaneous nephrolithotomy: A comparative study

Abstract

Abstract Background: Percutaneous nephrolithotomy (PCNL) is a major surgical procedure and the preferred treatment of choice for renal calculi (medium and large) size. Objectives: The study aims to determine complications between mini-PCNL and standard-PCNL, which is a comparative study to show which one has fewer complications and is safer for a patient with better outcomes. Materials and Methods: In a 1-year prospective study, clinical data from 44 patients who underwent PCNL (standard and mini) type between February 2021 and March 2022 for renal stones in Erbil city. Inclusion criteria included patients with renal stones (stag-horn, partial stag-horn, and non-stag-horn) and who are performing PCNL procedures. The exclusion criteria included patients who have a contraindication for doing PCNL. Results: Forty-four patients participated in the study, 17 underwent mini-PCNL, and 27 underwent standard PCNL. The mean hospital stay among the standard PCNL group (2.5 days) was significantly (P = 0.005) higher than that of the mini-PCNL group (1.7 days). Postoperative fever, infection, and sepsis (25%), bleeding (15.9%), hematuria (65.9%), and retained stone (20.5%). However, the differences in these rates were not significant between the groups. The rate of extravasation in the standard PCNL group (25.9%) was significantly (P = 0.032) higher than that of the mini-PCNL group (0%). Around two-thirds (64.7%) of the mini-PCNL group had no pain, compared with only 11.1% of the standard PCNL group (P = 0.001). Conclusion: The effectiveness of mini-PCNL is still under observation. Mini-PCNL postoperatively with less pain and limitation of blood loss, and less hospitalization for patients, with excellent results for stone free in comparison with standard PCNL.