Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jun 10;20(1):67.
doi: 10.1186/s12894-020-00636-z.

A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm: a prospective, comparative, multicenter and randomised study

Giorgio Bozzini  1 , Tahsin Batuhan Aydogan  2 , Alexander Müller  3 , Maria Chiara Sighinolfi  4 , Umberto Besana  1 , Alberto Calori  1 , Berti Lorenzo  1 , Alexander Govorov  5 , Dmitry Y Pushkar  5 , Giovannalberto Pini  6 , Antonio Luigi Pastore  7 , Javier Romero-Otero  8 , Bernardo Rocco  4 , Carlo Buizza  1
Affiliations
Randomized Controlled Trial

A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm: a prospective, comparative, multicenter and randomised study

Giorgio Bozzini et al. BMC Urol. .

Abstract

Background: Conventional Percutaneous Lithotripsy (PCNL) has been an effective, successful and easy approach for especially > 1 cm sized calyceal stones however risks of complications and nephron loss are inevitable. Our aim is to compare the efficacy and safety of PCNL, MiniPerc (MP) and UltraMiniPerc (UMP) for lower calyceal stones between 1 and 2 cm with a multicenter prospective randomized study.

Methods: Between January 2015 and June 2018, 132 consecutive patients with single lower calyceal stone were enrolled. Patients were randomized in three groups; A: PCNL; B: MP; C: UMP. 44 patients for the Group A, 47 for Group B and 41 for Group C. Exclusion criterias were the presence of coagulation impairments, age of < 18 or > 75, presence of infection or serious comorbidities. Patients were controlled with computerized tomography scan after 3 months. A negative CT or an asymptomatic patient with stone fragments < 3 mm size were the criteria to assess the stone-free status. Patient characteristics, stone free rates (SFR) s, complications and re-treatment rates were analyzed.

Results: The mean stone size were 16.38, 16.82 and 15.23 mm respectively in Group A, B and C(p = 0.34). The overall SFR was significantly higher in Group A (86.3%) and B (82.9%) as compared to Group C (78%)(p < 0.05). The re-treatment rate was significantly higher in Group C (12.1%) and complication rates was higher in Group A (13.6%) as compared to others(p < 0.05). The hospitalization was significantly shorter in Group C compared to Group A (p = 0.04).

Conclusions: PCNL and MP showed higher efficacy than UMP to obtain a better SFR. Auxiliary and re-treatment rates were higher in UMP. On the other hand for such this kind of stones PCNL had more complications. Overall evaluation favors MP as a better indication in stones 1-2 cm size.

Keywords: Lower calyces stones; Miniperc; PCNL; Percutaneous; Stone-free rate; Ultraminiperc.

PubMed Disclaimer

Conflict of interest statement

Not applicable. The authors have no conflict of interest.

References

    1. Cass AS, Grine WB, Jenkins JM, Jordan WR, Mobley TB, Myers DA. The incidence of lower-pole nephrolithiasis--increasing or not? Br J Urol. 1998;82(1):12–15. doi: 10.1046/j.1464-410x.1998.00684.x. - DOI - PubMed
    1. Moore SL, Bres-Niewada E, Cook P, Wells H, Somani BK. Optimal management of lower pole stones: the direction of future travel. Cent European J Urol. 2016;69(3):274–279. - PMC - PubMed
    1. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU guidelines on diagnosis and conservative Management of Urolithiasis. Eur Urol. 2016;69(3):468–474. doi: 10.1016/j.eururo.2015.07.040. - DOI - PubMed
    1. Mi Y, Ren K, Pan H, Zhu L, Wu S, You X, et al. Flexible ureterorenoscopy (F-URS) with holmium laser versus extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stone <2 cm: a meta-analysis. Urolithiasis. 2016;44(4):353–365. doi: 10.1007/s00240-015-0832-y. - DOI - PubMed
    1. Monga M, Best S, Venkatesh R, Ames C, Lee C, Kuskowski M, et al. Durability of flexible ureteroscopes: a randomized, prospective study. J Urol. 2006;176(1):137–141. doi: 10.1016/S0022-5347(06)00575-1. - DOI - PubMed

Publication types