Category: Clinical Stones: PCNL

MP32-12 - Systematic review and meta-analysis to compare success rates of percutaneous nephrolithotomy versus miniature percutaneous nephrolithotomy: An update

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Historically, miniature percutaneous nephrolithotomy (mPCNL) has been introduced for the treatment of pediatric patients with kidney stones. mPCNL has advantages over standard PCNL for blood loss, postoperative pain, and renal parenchymal damage, which are complications of larger instruments. We investigated to perform a systematic review and meta-analysis comparing stone-free rates between percutaneous nephrolithotomy (PCNL) and mPCNL using updated, more reliable evidence.


Methods :

Randomized controlled trials comparing PCNL and mPCNL for renal stones were identified from electronic databases. Stone-free rates for the procedures were compared by qualitative and quantitative syntheses (meta-analyses). Outcome variables are shown as odds ratios (ORs) with 95% confidence intervals (CIs).


Results :

Finally, eight articles were included in this study. Most recently published studies exhibited relatively low quality during quality assessment. Between mPCNL and PCNL (I2=51.0%, P=0.046), there was heterogeneity from each study. The Begg and Mazumdar rank correlation tests for each analysis showed no evidence of publication bias in the present meta-analysis between PCNL and mPCNL (P=0.805). Egger’s regression intercept tests also did not reveal any publication between PCNL and mPCNL (P=0.990). For the meta-analysis comparing success (stone-free) rates between PCNL and mPCNL, the forest plot using the random-effects model showed no diffrerence with an OR of 0.89 (95% CI, 1.46–1.71; P=0.730)


Conclusions :

mPCNL can be an effective procedure for selected patients with renal stones. Iin this meta-analysis, there was no difference of stone-free rate between PCNL and mPCNL.

Joo Yong Lee

Clinical Assistant Professor
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Joo Yong Lee, M.D., Ph.D.
Clinical Assistant Professor

Department of Urology, Severance Hospital,
Urological Science Institute, Yonsei University College of Medicine,
50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea

Tel. +82-2-2228-2320 / Fax. +82-2-312-2538 / Mobile. +82-10-6537-9779
E-mail. joouro@yuhs.ac / joouro@gmail.com

DO Kyung Kim

Hae Do Jung

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Kang Su Cho

Associate Professor
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Associate Professor, Department of Urology

Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Won Sik Ham

Associated professor
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seodaemun-gu, Seoul-t'ukpyolsi, Republic of Korea

Woong Kyu Han

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Koon Ho Rha

Professor
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seodaemun-gu, Seoul-t'ukpyolsi, Republic of Korea

Young Deuk Choi

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea