Comparison of clinical effects between mini-percutaneous nephrolithotomy and percutaneous nephrolithotomy for renal calculi

Objective To compare the clinical outcomes between standard percutaneous nephrolithotomy(PCNL)and mini-PCNL(mPCNL)for the treatment of renal calculi in order to improve the treatment of kidney stones.Methods From January 2009to July 2012,B-ultrasound guided PCNL was performed in 194patients with renal calculi and mPCNL in 178patients.Operation time,blood loss,one-stage stone-free rate,blood transfusion,serum creatinine(sCr),and glomerular filtration rate(GFR)were recorded.Postoperative complications,such as hemorrhage and infection were observed.Results The mPCNL group had a longer operation time than the PCNL group in various types of stones(P0.05).The blood loss in mPCNL was significantly less than that in PCNL(P0.05).The one-stage stone-free rate for multiple stones in renal calices in the mPCNL group was significantly higher than that in the PCNL group(90.1%vs.76.5%,P0.05).But the clearance rate for simple renal pelvis stone in the mPCNL group was significantly lower than that in the PCNL group(78.5% vs.95.1%,P0.05).Compared with preoperative values,sCr was significantly increased on day 1and 3postoperatively in the mPCNL group,and on day 3and month 1postoperatively in the PCNL group(P0.05).The level of sCr was significantly higher in the mPCNL group than that in the PCNL group on day 1and 3postoperatively(P0.05),while one month later,the level of sCr was significantly lower in mPCNL group than that in PCNL group(P0.05).The GFR was significantly decreased as compared with preoperative one in all patients(P 0.05).The GFR was significantly higher in PCNL group than that in mPCNL group on day 1and 3postoperatively(P 0.05).Conclusion The PCNL may be suitable for large renal pelvis stone,while mPCNL has advantages in the treatment of renal calyx stone.Renal function is less affected by PCNL as compared with mPCNL.Renal function impairment caused by expansion in the establishment of channel process is far lower than caused by the perfusion pressure.