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Published in: Urolithiasis 1/2024

01-12-2024 | Research

A randomized controlled trial comparing infectious complications using mini perc with and without suction for renal stones less than 3 cm in size

Authors: Niramya Pathak, Sahil Agrawal, Aditya Parikh, Nitiraj Shete, Abhishek Singh, Arvind Ganpule, Ravindra Sabnis, Mahesh Desai

Published in: Urolithiasis | Issue 1/2024

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Abstract

The purpose was to do a study to compare infectious complications in patients operated for MiniPerc or Minimally invasive Percutaneous Nephrolithotomy (MPCNL) using MIP and MPCNL with suction using Shah Superperc sheath for medium-sized renal stones less than 3 cm in size. The primary objective of this study is to compare the infectious complications and the secondary objectives are to compare stone-free rates, complication rates and operative times. A prospective randomized controlled trial with patients having proximal ureteral and renal stones of 10–30 mm size and planned for MPCNL done at a single institute. A total of 80 consecutively admitted patients with written informed consent were included for randomization with 40 patients in each arm of MPCNL and suction MPCNL. The median age in MPCNL and suction MPCNL arms were 48 and 49 years, the median stone size of 15.45 and 16.7 cm, the Median stone volume of 1576.2 vs 1752 mm3, and the median stone density of 1258 and 1250 Hu, the median hospital stay of 3 days in both arms were comparable. Infectious complications were comparable in both arms. Operative time was significantly less in the suction MPCNL group (26.5 min–IQR 17–34.8) than in the MPCNL group (34.8 min–IQR 20–45), p = 0.021 and stone-free rates (SFR), were more in Suction MPCNL arm 97.5% than in MPCNL 87.5%, p = 0.04. Overall, the complication rates were comparable in both arms. Suction MPCNL procedure resulted in shorter operating times and more SFR than conventional MPCNL with comparable complication rates.
Literature
2.
go back to reference Ruhayel Y, Tepeler A, Dabestani S, MacLennan S, Petřík A, Sarica K et al (2017) Tract sizes in miniaturized percutaneous nephrolithotomy: a systematic review from the European association of urology urolithiasis guidelines Panel. Eur Urol 72(2):220–235CrossRefPubMed Ruhayel Y, Tepeler A, Dabestani S, MacLennan S, Petřík A, Sarica K et al (2017) Tract sizes in miniaturized percutaneous nephrolithotomy: a systematic review from the European association of urology urolithiasis guidelines Panel. Eur Urol 72(2):220–235CrossRefPubMed
3.
go back to reference Lopes T, Sangam K, Alken P, Barroilhet BS, Saussine C, Shi L et al (2011) The clinical research office of the endourological society percutaneous nephrolithotomy global study: tract dilation comparisons in 5537 patients. J Endourol 25(5):755–762CrossRefPubMed Lopes T, Sangam K, Alken P, Barroilhet BS, Saussine C, Shi L et al (2011) The clinical research office of the endourological society percutaneous nephrolithotomy global study: tract dilation comparisons in 5537 patients. J Endourol 25(5):755–762CrossRefPubMed
4.
go back to reference Kukreja RA (2018) Should mini percutaneous nephrolithotomy (MiniPNL/Miniperc) be the ideal tract for medium-sized renal calculi (15–30 mm)? World J Urol 36(2):285–291CrossRefPubMed Kukreja RA (2018) Should mini percutaneous nephrolithotomy (MiniPNL/Miniperc) be the ideal tract for medium-sized renal calculi (15–30 mm)? World J Urol 36(2):285–291CrossRefPubMed
5.
go back to reference Giusti G, Piccinelli A, Taverna G, Benetti A, Pasini L, Corinti M et al (2007) Miniperc? No, thank you! Eur Urol 51(3):810–814CrossRefPubMed Giusti G, Piccinelli A, Taverna G, Benetti A, Pasini L, Corinti M et al (2007) Miniperc? No, thank you! Eur Urol 51(3):810–814CrossRefPubMed
6.
go back to reference Wu C, Hua LX, Zhang JZ, Zhou XR, Zhong W, Ni HD (2017) Comparison of renal pelvic pressure and postoperative fever incidence between standard- and mini-tract percutaneous nephrolithotomy. Kaohsiung J Med Sci 33(1):36–43CrossRefPubMed Wu C, Hua LX, Zhang JZ, Zhou XR, Zhong W, Ni HD (2017) Comparison of renal pelvic pressure and postoperative fever incidence between standard- and mini-tract percutaneous nephrolithotomy. Kaohsiung J Med Sci 33(1):36–43CrossRefPubMed
7.
go back to reference Zanetti SP, Boeri L, Gallioli A, Talso M, Montanari E (2017) Minimally invasive PCNL-MIP. Arch Esp Urol 70(1):226–234PubMed Zanetti SP, Boeri L, Gallioli A, Talso M, Montanari E (2017) Minimally invasive PCNL-MIP. Arch Esp Urol 70(1):226–234PubMed
8.
go back to reference Nagele U, Horstmann M, Sievert KD, Kuczyk MA, Walcher U, Hennenlotter J et al (2007) A newly designed amplatz sheath decreases intrapelvic irrigation pressure during mini-percutaneous nephrolitholapaxy: an in-vitro pressure-measurement and microscopic study. J Endourol 21(9):1113–1116CrossRefPubMed Nagele U, Horstmann M, Sievert KD, Kuczyk MA, Walcher U, Hennenlotter J et al (2007) A newly designed amplatz sheath decreases intrapelvic irrigation pressure during mini-percutaneous nephrolitholapaxy: an in-vitro pressure-measurement and microscopic study. J Endourol 21(9):1113–1116CrossRefPubMed
9.
go back to reference Mager R, Balzereit C, Gust K, Hüsch T, Herrmann T, Nagele U et al (2016) The hydrodynamic basis of the vacuum cleaner effect in continuous-flow PCNL instruments: an empiric approach and mathematical model. World J Urol 34(5):717–724CrossRefPubMed Mager R, Balzereit C, Gust K, Hüsch T, Herrmann T, Nagele U et al (2016) The hydrodynamic basis of the vacuum cleaner effect in continuous-flow PCNL instruments: an empiric approach and mathematical model. World J Urol 34(5):717–724CrossRefPubMed
10.
go back to reference Zeng G, Zhu W, Lam W (2018) Miniaturised percutaneous nephrolithotomy: Its role in the treatment of urolithiasis and our experience. Asian J Urol 5(4):295–302CrossRefPubMedPubMedCentral Zeng G, Zhu W, Lam W (2018) Miniaturised percutaneous nephrolithotomy: Its role in the treatment of urolithiasis and our experience. Asian J Urol 5(4):295–302CrossRefPubMedPubMedCentral
11.
go back to reference Alsmadi J, Fan J, Zhu W, Wen Z, Zeng G (2018) The influence of super-mini percutaneous nephrolithotomy on renal pelvic pressure in vivo. J Endourol 32(9):819–823CrossRefPubMed Alsmadi J, Fan J, Zhu W, Wen Z, Zeng G (2018) The influence of super-mini percutaneous nephrolithotomy on renal pelvic pressure in vivo. J Endourol 32(9):819–823CrossRefPubMed
12.
go back to reference Shah K, Agrawal MS, Mishra DK (2017) Superperc: a new technique in minimally-invasive percutaneous nephrolithotomy. Indian J Urol IJU J Urol Soc India 33(1):48–52 Shah K, Agrawal MS, Mishra DK (2017) Superperc: a new technique in minimally-invasive percutaneous nephrolithotomy. Indian J Urol IJU J Urol Soc India 33(1):48–52
13.
go back to reference Seitz C, Desai M, Häcker A, Hakenberg OW, Liatsikos E, Nagele U et al (2012) Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol 61(1):146–158CrossRefPubMed Seitz C, Desai M, Häcker A, Hakenberg OW, Liatsikos E, Nagele U et al (2012) Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol 61(1):146–158CrossRefPubMed
14.
go back to reference Xu G, He Y, Zhao H, Jiang X, Feng G, Yang W et al (2016) Mini-nephroscope combined with pressure suction: an effective tool in MPCNL for intrarenal stones in patients with urinary tract infections. Urolithiasis 44(5):445–450CrossRefPubMed Xu G, He Y, Zhao H, Jiang X, Feng G, Yang W et al (2016) Mini-nephroscope combined with pressure suction: an effective tool in MPCNL for intrarenal stones in patients with urinary tract infections. Urolithiasis 44(5):445–450CrossRefPubMed
15.
go back to reference Lievore E, Boeri L, Zanetti SP, Fulgheri I, Fontana M, Turetti M et al (2021) Clinical comparison of mini-percutaneous nephrolithotomy with vacuum cleaner effect or with a vacuum-assisted access sheath: a single-center experience. J Endourol. 35(5):601–608CrossRefPubMed Lievore E, Boeri L, Zanetti SP, Fulgheri I, Fontana M, Turetti M et al (2021) Clinical comparison of mini-percutaneous nephrolithotomy with vacuum cleaner effect or with a vacuum-assisted access sheath: a single-center experience. J Endourol. 35(5):601–608CrossRefPubMed
16.
go back to reference Lai D, Chen M, Sheng M, Liu Y, Xu G, He Y et al (2020) Use of a novel vacuum-assisted access sheath in minimally invasive percutaneous nephrolithotomy: a feasibility study. J Endourol 34(3):339–344CrossRefPubMed Lai D, Chen M, Sheng M, Liu Y, Xu G, He Y et al (2020) Use of a novel vacuum-assisted access sheath in minimally invasive percutaneous nephrolithotomy: a feasibility study. J Endourol 34(3):339–344CrossRefPubMed
17.
go back to reference Du C, Song L, Wu X, Fan D, Zhu L, Liu S et al (2018) Suctioning minimally invasive percutaneous nephrolithotomy with a patented system is effective to treat renal staghorn calculi: a prospective multicenter study. Urol Int 101(2):143–149CrossRefPubMed Du C, Song L, Wu X, Fan D, Zhu L, Liu S et al (2018) Suctioning minimally invasive percutaneous nephrolithotomy with a patented system is effective to treat renal staghorn calculi: a prospective multicenter study. Urol Int 101(2):143–149CrossRefPubMed
18.
go back to reference Zhu Z, Cui Y, Zeng H, Li Y, He C, Chen J et al (2019) Suctioning versus traditional minimally invasive percutaneous nephrolithotomy to treat renal staghorn calculi: a case-matched comparative study. Int J Surg Lond Engl. 72:85–90CrossRef Zhu Z, Cui Y, Zeng H, Li Y, He C, Chen J et al (2019) Suctioning versus traditional minimally invasive percutaneous nephrolithotomy to treat renal staghorn calculi: a case-matched comparative study. Int J Surg Lond Engl. 72:85–90CrossRef
19.
go back to reference Huang J, Song L, Xie D, Li M, Deng X, Hu M et al (2016) A Randomized study of minimally invasive percutaneous nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery. BMC Urol 16(1):71CrossRefPubMedPubMedCentral Huang J, Song L, Xie D, Li M, Deng X, Hu M et al (2016) A Randomized study of minimally invasive percutaneous nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery. BMC Urol 16(1):71CrossRefPubMedPubMedCentral
20.
go back to reference Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M et al (2016) The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8):801–810CrossRefPubMedPubMedCentral Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M et al (2016) The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8):801–810CrossRefPubMedPubMedCentral
21.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral
22.
go back to reference Somani BK, Desai M, Traxer O, Lahme S (2014) Stone-free rate (SFR): a new proposal for defining levels of SFR. Urolithiasis 42(2):95CrossRefPubMed Somani BK, Desai M, Traxer O, Lahme S (2014) Stone-free rate (SFR): a new proposal for defining levels of SFR. Urolithiasis 42(2):95CrossRefPubMed
23.
go back to reference Assel M, Sjoberg D, Elders A, Wang X, Huo D, Botchway A et al (2019) Guidelines for reporting of statistics for clinical research in urology. J Urol 201(3):595–604CrossRefPubMedPubMedCentral Assel M, Sjoberg D, Elders A, Wang X, Huo D, Botchway A et al (2019) Guidelines for reporting of statistics for clinical research in urology. J Urol 201(3):595–604CrossRefPubMedPubMedCentral
24.
go back to reference Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 1(2):100–107CrossRefPubMedPubMedCentral Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 1(2):100–107CrossRefPubMedPubMedCentral
25.
go back to reference Xu G, Liang J, He Y, Li X, Yang W, Lai D et al (2020) Comparison of two different minimally invasive percutaneous nephrostomy sheaths for the treatment of staghorn stones. BJU Int. 125(6):898–904CrossRefPubMed Xu G, Liang J, He Y, Li X, Yang W, Lai D et al (2020) Comparison of two different minimally invasive percutaneous nephrostomy sheaths for the treatment of staghorn stones. BJU Int. 125(6):898–904CrossRefPubMed
26.
go back to reference Zhong W, Zeng G, Wu K, Li X, Chen W, Yang H (2008) Does a smaller tract in percutaneous nephrolithotomy contribute to high renal pelvic pressure and postoperative fever? J Endourol 22(9):2147–2151CrossRefPubMed Zhong W, Zeng G, Wu K, Li X, Chen W, Yang H (2008) Does a smaller tract in percutaneous nephrolithotomy contribute to high renal pelvic pressure and postoperative fever? J Endourol 22(9):2147–2151CrossRefPubMed
Metadata
Title
A randomized controlled trial comparing infectious complications using mini perc with and without suction for renal stones less than 3 cm in size
Authors
Niramya Pathak
Sahil Agrawal
Aditya Parikh
Nitiraj Shete
Abhishek Singh
Arvind Ganpule
Ravindra Sabnis
Mahesh Desai
Publication date
01-12-2024
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 1/2024
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-023-01487-7

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