Comparative analysis of the results of standard and minipercutaneous nephrolithotripsy for staghorn stones

Abstract

Introduction. There are conflicting data in the literature on the results of mini-percutaneous nephrolithotripsy (PCNL) in staghorn stones.Objective. To compare the results of standard and mini-PCNL.Materials and methods. The results of PCNL in 90 patients with staghorn stones were analyzed, which were divided into two groups. In the I group, 58 (64.4%) patients underwent standard PNL with a nephroscope 24 Fr, in the II group, 32 (35.6%) patients underwent mini-PCNL with an endoscope 15 Fr. The operative time and the number of postoperative complications were compared. To assess the effectiveness of PCNL, an overview radiography or native computed tomography was performed. The operation was considered successful with residual fragments less than 3 mm.Results. Operative time, number of complications and blood transfusions, the effectiveness of PCNL in groups I and II were 80.0 ± 20.6 and 96.5 ± 25.0 min, 24.1% and 15.6%, 10.3% and 3.1%, 86.2% and 84.4%. Additional interventions were resorted to in 7 (12.1%) patients in I group, and in 4 (12.5%) patients in II group. Complications in I and II groups were observed in 14 (24.1%) and 5 (15.6%) cases. The frequency of blood transfusions was significantly higher after standard PCNL (10.3% / 3.1%, p < 0.05). Complications of grade III with mini-PCNL, replacement of an incorrectly installed stent was included in 2 patients, and with standard PCNL, ureteral stenting with urine leakage through the nephrostomic tract in 2 patients, drainage of the pleural cavity in one case.Conclusion. Standard PCNL is an effective method in staghorn stones, but the number of complications after it remains higher. In selected patients with staghorn stones, the results of mini-PCNL are comparable to those of standard PCNL.

Keywords

• kidney stones
• staghorn stones
• percutaneous nephrolithotripsy
• minipercutaneous nephrolithotripsy