Contacts: Belousov Igor Ivanovich, belrost_dept@mail.ru

Introduction. Currently, there are studies that evaluate the potential of mini-percutaneous nephrolithotripsy (mini-PNL) in the treatment of kidney stones up to 2 cm in size. At the same time, there are publications that compare the effectiveness of PNL with endoscopes of various diameters with such stones. At the same time, there are practically no studies where the possibility of making large single kidney stone and staghorn stones of PNL is studied with an endoscope of small diameter in comparison with a standard size endoscope.

Materials and methods. The effects of PNL 96 patients with large single kidney stone > 20 mm, and staghorn stones were investigated. Depending on the size of the instrument used, patients are separated into 2 groups. Group 1, 45 patients, operated on with an endoscope of standard size, 26Ch; in group 2, 51 patients, PNL conducted with a mini-endoscope, 15Ch. In accordance with the type of stones, separation into subgroups has been introduced: large single kidney stones - subgroups 1A and 2A; staghorn stones - subgroups 1B and 2B. The criterion of efficiency is the complete removal of a stone in one operation with one access. The assessment of complications was carried out using the Clavien-Dindo scale adapted for PNL. Non-parametric statistics were used for statistical processing of results (Statistica 10.2; StatSoth Inc., USA).

Results. The physical parameters of the kidney stones affect the duration of the PNL, which, in turn, is reduced when using the standard size of the endoscope. At the same time, the effectiveness of PNL is comparable in subgroups with staghorn stones and significantly higher in the fragmentation of large single kidney stone with a small-sized endoscope. At the same time, mini-PNL in comparison with the PNL has a higher safety profile and significantly reduces the length of time the patient is in hospital.

Conclusion. Mini-PNL can be considered as the preferred method of surgery for large single kidney stones in relation to PNL due to its higher efficiency and safety profile. In the case of the use of mini-PNL in the treatment of staghorn stones, these advantages can be achieved in selected patients who do not have excess body weight over the standard. 

For citation: Belousov I.I., Kogan M.I., Trusov P.V. Mini-PNCL vs PNCL: comparative analysis of efficiency and safety of nephrolithotripsy techniques with large single and staghorn stones. Experimental and clinical urology 2019;(3):84-91