Mini-Perc for Renal Stones—A Single Center Experience and Literature Review
Aim: The aim of this study was to analyze the outcomes of miniaturized nephrolithotomy (mini-perc) in the management of renal stones with a diameter smaller than 20 mm. Materials and Methods: We retrospectively reviewed the records of 102 patients who underwent mini-perc between March 2015 and March...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/6/1083 |
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| author | Victor-Mihail Cauni Mihai Dragutescu Bogdan Mihai Gabriel-Petre Gorecki Liana Ples Romina-Marina Sima Cristian Persu |
| author_facet | Victor-Mihail Cauni Mihai Dragutescu Bogdan Mihai Gabriel-Petre Gorecki Liana Ples Romina-Marina Sima Cristian Persu |
| author_sort | Victor-Mihail Cauni |
| collection | DOAJ |
| description | Aim: The aim of this study was to analyze the outcomes of miniaturized nephrolithotomy (mini-perc) in the management of renal stones with a diameter smaller than 20 mm. Materials and Methods: We retrospectively reviewed the records of 102 patients who underwent mini-perc between March 2015 and March 2020 in our department. The primary objective was the stone-free rate, but we also analyzed the retreatment rate, complications, hospital stay, operative time and reduction in hemoglobin level. All these patients had this technique as their first-line treatment, in a prone position, using a 16 Fr sheath size. Data were compared to a series of patients from the literature, treated with conventional PCNL. Results: The patients had calculus limited to either a single calyx or just extending to the renal pelvis, and stone size was less than 20 mm in its maximal dimension. The intrarenal stone location was in the upper calyx in 7 cases, middle calyx in 20 cases and lower calyx in 46 cases, and there were 29 patients with renal pelvis stone. The male to female ratio was 1.5:1, and the median age was 48.4 years. The average stone size was 17.4 mm in diameter (ranging between 9 and 20 mm) and all cases underwent Ho-YaG laser lithotripsy, ballistic energy and combined ultrasonic and ballistic lithotripsy. At the end of the procedure, an antegrade double J stent was placed under fluoroscopy for a maximum of 2 weeks in 42 cases, while 9 cases needed a nephrostomy tube 12–14 F. A total of 51 cases were totally tubeless. Our median operative time was 61 min (ranging from 35 to 75 min). The median hospitalization stay was 3.8 days. The stone free rate was 90.1% after one procedure, only nine (8.8%) cases needed a “second look” flexible ureteroscopy, and the final stone-free rate was 98% (absence of detectable calculi on ultrasound, KUB or non-contrast CT scan). The overall complication rate was 6.86% (Clavien classification I—57.14%; II—28.5%; III—14.2%), while no Clavien IV or V complications were reported. No patient required a blood transfusion, and mean hemoglobin loss was 0.81 mg/dL. Overall, our results are better than similar data for conventional PCNL in the literature. Conclusions: The “mini-perc” technique is an effective procedure for the treatment of the renal lithiasis that is less or equal to 2 cm. The results demonstrated that this minimally invasive technique is associated with a higher stone-free rate and minimal complications. |
| first_indexed | 2024-03-11T06:41:41Z |
| format | Article |
| id | doaj.art-4b1c399203764f28b7e2c6eb5b22e8fd |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T06:41:41Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4b1c399203764f28b7e2c6eb5b22e8fd2023-11-17T10:34:07ZengMDPI AGDiagnostics2075-44182023-03-01136108310.3390/diagnostics13061083Mini-Perc for Renal Stones—A Single Center Experience and Literature ReviewVictor-Mihail Cauni0Mihai Dragutescu1Bogdan Mihai2Gabriel-Petre Gorecki3Liana Ples4Romina-Marina Sima5Cristian Persu6Department of Urology, Colentina Clinical Hospital, 020125 Bucharest, RomaniaDepartment of Urology, Colentina Clinical Hospital, 020125 Bucharest, RomaniaDepartment of Urology, Colentina Clinical Hospital, 020125 Bucharest, RomaniaDepartment of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Urology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaAim: The aim of this study was to analyze the outcomes of miniaturized nephrolithotomy (mini-perc) in the management of renal stones with a diameter smaller than 20 mm. Materials and Methods: We retrospectively reviewed the records of 102 patients who underwent mini-perc between March 2015 and March 2020 in our department. The primary objective was the stone-free rate, but we also analyzed the retreatment rate, complications, hospital stay, operative time and reduction in hemoglobin level. All these patients had this technique as their first-line treatment, in a prone position, using a 16 Fr sheath size. Data were compared to a series of patients from the literature, treated with conventional PCNL. Results: The patients had calculus limited to either a single calyx or just extending to the renal pelvis, and stone size was less than 20 mm in its maximal dimension. The intrarenal stone location was in the upper calyx in 7 cases, middle calyx in 20 cases and lower calyx in 46 cases, and there were 29 patients with renal pelvis stone. The male to female ratio was 1.5:1, and the median age was 48.4 years. The average stone size was 17.4 mm in diameter (ranging between 9 and 20 mm) and all cases underwent Ho-YaG laser lithotripsy, ballistic energy and combined ultrasonic and ballistic lithotripsy. At the end of the procedure, an antegrade double J stent was placed under fluoroscopy for a maximum of 2 weeks in 42 cases, while 9 cases needed a nephrostomy tube 12–14 F. A total of 51 cases were totally tubeless. Our median operative time was 61 min (ranging from 35 to 75 min). The median hospitalization stay was 3.8 days. The stone free rate was 90.1% after one procedure, only nine (8.8%) cases needed a “second look” flexible ureteroscopy, and the final stone-free rate was 98% (absence of detectable calculi on ultrasound, KUB or non-contrast CT scan). The overall complication rate was 6.86% (Clavien classification I—57.14%; II—28.5%; III—14.2%), while no Clavien IV or V complications were reported. No patient required a blood transfusion, and mean hemoglobin loss was 0.81 mg/dL. Overall, our results are better than similar data for conventional PCNL in the literature. Conclusions: The “mini-perc” technique is an effective procedure for the treatment of the renal lithiasis that is less or equal to 2 cm. The results demonstrated that this minimally invasive technique is associated with a higher stone-free rate and minimal complications.https://www.mdpi.com/2075-4418/13/6/1083mini-perckidney lithiasisminimally invasive nephrolithotomy |
| spellingShingle | Victor-Mihail Cauni Mihai Dragutescu Bogdan Mihai Gabriel-Petre Gorecki Liana Ples Romina-Marina Sima Cristian Persu Mini-Perc for Renal Stones—A Single Center Experience and Literature Review Diagnostics mini-perc kidney lithiasis minimally invasive nephrolithotomy |
| title | Mini-Perc for Renal Stones—A Single Center Experience and Literature Review |
| title_full | Mini-Perc for Renal Stones—A Single Center Experience and Literature Review |
| title_fullStr | Mini-Perc for Renal Stones—A Single Center Experience and Literature Review |
| title_full_unstemmed | Mini-Perc for Renal Stones—A Single Center Experience and Literature Review |
| title_short | Mini-Perc for Renal Stones—A Single Center Experience and Literature Review |
| title_sort | mini perc for renal stones a single center experience and literature review |
| topic | mini-perc kidney lithiasis minimally invasive nephrolithotomy |
| url | https://www.mdpi.com/2075-4418/13/6/1083 |
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