Introduction. Staghorn and complex kidney stones are a serious problem in urology, requiring a balance between efficacy and safety when choosing optimal surgery.
Aim: to evaluate the efficacy and safety of mini-percutaneous laser nephrolithotripsy (mini-PNL) in combination with additional endoscopic intrarenal techniques for staghorn and complex kidney stones.
Materials and methods. A prospective analysis of 69 patients who underwent mini-PNL in combination with additional endoscopic intrarenal approaches was performed: micro-PNL – 33 patients, antegrade or retrograde flexible ureterorenoscopy – 19 and 17 patients, respectively) for staghorn/complex kidney stones.
Results. The age of patients ranged from 22 to data from 69 years; there was a predominance of women – 60.9%. All renal stones were large (24–54 mm in size) and complex, with staghorn calculi predominating at 84,1%. In the mini-PNL supplemented by micro-PNL, the stone-free rate (SFR) on day 5 and 3 months after surgery was 90.9 and 97.0%, respectively, the incidence of complications according to Clavien-Dindo grades 1–2 was 9.1%, grade 3 – in 6%, there was no need for blood transfusion. In the mini-PNL supplemented by antegrade or retrograde flexible ureterorenoscopy groups, the SFR on day 5 and 3 months after surgery was 88.9 and 94.4%, respectively, postoperative complications according to the Clavien-Dindo classification of grades 1–2 were diagnosed in 11.1% of cases, grade 3 – 8.3% of cases, there was no need for blood transfusion.
Conclusions. Combinations of mini-PNL with additional endoscopic intrarenal approaches (micro-PNL, antegrade or retrograde flexible ureterorenoscopy) for coral/complex kidney stones are effective (SFR 3 months after surgery was 95.7%) and safe (postoperative complications according to Clavien-Dindo grades 1–3 were diagnosed in 17.4% of cases, there were no hemorrhagic complications with transfusion of blood components).
