WCE 2017: Mini-Percutaneous Nephrolithotomy: Initial Experience

Vancouver, Canada (UroToday.com) Dr. Saman Moazami, chief resident of urology at Montefiore Medical Center, presented his initial findings to aid in developing the role of mini-PCNL in kidney stone surgery. Dr. Moazami began the presentation by assessing the advantages of performing a modification of the standard PCNL procedure, known as the mini-PCNL. These advantages include a reduction of blood loss, post-operative pain, and potential risk of renal damage. In addition, previous studies have indicated that mini-PCNL results in comparable stone-free rates to the traditional technique, with a safer and less invasive approach.

The purpose of this study was to prospectively evaluate the outcomes of patients who underwent a mini-PCNL using the 12 French Storz Miniperc system.
For this assessment, 22 patients who received a mini-PCNL received a pre-operative and post-operative CT scan to compare several clinical outcomes, including stone size, complications, post-operative drain management, and length of hospital stay. Stone fragments >3 mm were considered significant.

The outcomes from this study revealed no intraoperative or postoperative complications or emergency visits, 68% of patients were discharged on the same day of the operation, and only one patient required a nephrostomy tube. 86% of the patients were stone-free at 4-6 weeks post-operative, indicating the overall effectiveness of the mini-PCNL in producing stone-free rates similar to that of traditional PCNL.

Dr. Moazami concluded that mini-PCNL is an optimal and safe approach for renal and proximal ureteral calculi > 1 cm. Mini-PCNL serves as a clinically beneficial alternative to standard PCNL due to an overall decrease in complication rate, length of hospital stay, invasiveness of the procedure, and decreased need for post-operative tube insertion. Additionally, mini-PCNL is similarly effective to the standard PCNL for stone-free rates, solidifying its effectiveness for the management of nephrolithiasis.

Presented by: Saman Moazami, MD

Authors: Saman Moazami, Lanna Cheuck, Joshua Stern
Affiliations: Montefiore Medical Center

Written by: Taylor Capretz, Department of Urology, University of California-Irvine at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.