Introduction
\nPercutaneous nephrolithotomy (PCNL) is the endoscopic procedure of choice for the treatment of large renal stones. Standard access tract size ranges from 24 to 30 Fr; however, smaller calibers such as mini-percutaneous nephrolithotomy (mini-PCNL) are increasingly being adopted. Together with improvements in lithotripsy systems, these advances have demonstrated a positive impact on stone-free rates (SFR).<\/p>\n
Materials & Methods
\nA descriptive retrospective study was conducted including 73 patients who underwent PCNL over a 5-year period. Patients were divided into two groups according to stone size (<3 cm and \u22653 cm). Each group was stratified based on the surgical approach used: standard PCNL (sPCNL) or mini-PCNL. Furthermore, patients were categorized according to whether surgery was performed before or after 2023, the year in which a higher-power Holmium laser was introduced in our department. Stone-free rate (SFR) was recorded for each subgroup and defined as the absence of residual fragments \u22654 mm. Additional variables analyzed included puncture site, number of tracts, and stone characteristics (size, Hounsfield Units [HU], and Guy's stone score). Statistical analysis was performed using R software, applying a multiple logistic regression model.<\/p>\n
Results
\nAmong the 73 patients included, 23 underwent standard PCNL and 50 underwent mini-PCNL. Mean stone size was 2.1 cm, with a mean density of 1057.8 HU. The most frequent stone location was the renal pelvis. Stone complexity according to Guy's stone score was: Grade I (n=5), Grade II (n=27), Grade III (n=27), and Grade IV (n=14). The most commonly used puncture site was the lower calyceal group. Multitract access was required in 9 patients. In stones \u22653 cm, before 2023 the SFR was 16% for standard PCNL and 0% for mini-PCNL, whereas after 2023 the SFR for mini-PCNL increased to 33%. In stones <3 cm, before 2023 the SFR was 59% for standard PCNL and 50% for mini-PCNL, while after 2023 the SFR for mini-PCNL reached 57%. No standard PCNL procedures were performed after 2023.<\/p>\n
Conclusions
\nIn our series, stone size <3 cm was associated with significantly higher stone-free rates (p < 0.05). Despite the apparent improvement in outcomes with the mini-percutaneous approach, no statistically significant differences were observed.<\/p>\n","protected":false},"excerpt":{"rendered":"
Introduction Percutaneous nephrolithotomy (PCNL) is the endoscopic procedure of choice for the treatment of large renal stones. Standard access tract size ranges from 24 to 30 Fr; however, smaller calibers such as mini-percutaneous nephrolithotomy (mini-PCNL) are increasingly being adopted. Together … read more<\/a><\/p>","protected":false},"author":3,"featured_media":215,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-214","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/214","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/215"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=214"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=214"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=214"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}