Role of Mini-Percutaneous Nephrolithotomy in the Treatment of Renal Stones

Objective: To determine the role of mini-percutaneus nephrolithotomy in the renal stones management and its post-operative complications.

Methodology: This descriptive study was conducted at Institute of Kidney Diseases (IKD), Hayatabad Medical Complex, Peshawar from January 2017 to January 2019 over 154 patients. Baseline investigations were carried out for all the patients fulfilling inclusion criteria. All patients provided written, informed consent before the procedure. Demography, operative parameters, and outcomes were analyzed in the study. X-ray KUB was done postoperatively for all patients and follow-up ultrasound examination/NCCT at follow-up visit at 1 month.

Results: Out of 154 patients, 90(58.44%) were male and 64(41.55%) were female. Mean age of the subjects were 33.3 ± 8.5 (15-70) years. 84(54.54%) patients had left renal stones while 70(45.45%) patients had right renal stones. The mean stone size was 18.52(15–20) mm. Access to the Pelvicalyceal system was successful in all (100%) cases. The mean operation time was 53.14(45–60) minutes. The mean hospital stay was 2(2-3) days. The targeted calyces were upper in 10(6.49%), middle in 90(58.44%), and lower in 54(35.06%) patients. Complete Stone clearance was achieved in 140(90.90%) patients while 14(9.09%) patients had residual stone fragments, out of which 2 patients underwent ureteroscopic fragmentation while 4 patients required post op extracorporeal shock wave lithotripsy (ESWL) for the residual stones. No major complications occurred.

Conclusion: Mini- percutaneus nephrolithotomy is an effective minimally invasive modality of treatment in renal stones and is associated with excellent stone clearance, less morbidity and shorter hospital stay.

Keywords: Percutaneous nephrolithotomy, mini-PCNL, Renal stones.