Efficacy of Mini-perc in Patients
with less than 2 cm Renal CalculiA Prospective Observational Study
Published: January 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/42008.13415
Abid Raval, Kshitij Raghuvanshi, DK Jain, Rajesh Dhake, Hrishikesh Deshmukh, Shams Iqbal
1. Senior Resident, Department of Urology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
2. Senior Resident, Department of Urology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
3. Head, Department of Urology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
4. Associate Professor, Department of Urology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
5. Associate Professor, Department of Urology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
6. Associate Professor, Department of Urology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India.
Correspondence
Dr. Abid Raval,
Department of Urology, Bharati Hospital, Satara Road, Dhanakwadi, Katraj, Pune-411043, Maharashtra, India.
E-mail: abidr07@gmail.com
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.
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