Efficacy of Mini-perc in Patients with less than 2 cm Renal CalculiA Prospective Observational Study PC03-PC07
Dr. Abid Raval,
Department of Urology, Bharati Hospital, Satara Road, Dhanakwadi, Katraj, Pune-411043, Maharashtra, India.
Introduction: Miniaturisation of the instruments in Percutaneous Nephrolithotomy (PCNL) is advantageous over standard PCNL procedure in patients with renal stone <2 cm in size.
Aim: To assess efficacy and safety of miniaturised (mini-Perc) and standard PCNL in patients with renal calculi ≥2 cm in size.
Materials and Methods: This prospective observational study included patients with age >18 years and renal stones ≥2 cm in size. Patients were equally randomised to standard PCNL and mini-Perc group. The primary outcomes included operative time, stone clearance, postoperative analgesic requirement, and associated complications. Association between qualitative variables were evaluated using Chi-square test and Fisher-exact test; while, comparison of quantitative data was performed using unpaired t-test or Mann-Whitney U test.
Results: A total of 100 patients (standard PCNL, n=50; mini-Perc, n=50) were enrolled. The mean age (years) of patients in standard PCNL and mini-Perc were 40.78 and 39.79, respectively. The complete stone clearance rate was comparable between miniPerc and standard PCNL (92% vs 94%). The mean operative time (minutes) was significantly more with mini-Perc than standard PCNL (78.86 vs 73.72; p<0.05). Four patients from standard PCNL group had bleeding and none from mini-perc reported bleeding. Other complications observed were fever and pelvic perforation. Duration of hospitalisation (days) was significantly shorter in mini-Perc group as compared to standard PCNL (3.16 versus 4.12; p<0.01) group. Drop in haemoglobin and drop in Packed Cell Volume (PCV) were significantly reduced in mini-Perc group than standard PCNL (p<0.01).
Conclusion: Both the mini-Perc and standard PCNL techniques were effective and well-tolerated in patients with renal calculi ≥2 cm in size. However, shorter duration of hospitalisation and longer operative time were associated with mini-Perc treatment.