Miniaturised percutaneous nephrolithotomy: Its role in the treatment of urolithiasis and our experience
Guohua Zengab*(),Wei Zhuab,Wayne Lamc
a. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China b. Guangzhou Institute of Urology, Guangdong Key Laboratory of Urology, Guangzhou, China c. Division of Urology, Department of Surgery, Queen Mary Hospital, Hong Kong, China
Miniaturized percutaneous nephrolithotomy (PCNL) procedures have gained increased popularity in recent years. They aim to reduce percutaneous tract size in order to lower complication rates, while maintaining high stone-free rates. Recently, miniaturized PCNL techniques have further expanded, and can currently be classified into mini-PCNL, minimally invasive PCNL (MIP), Chinese mini-PCNL (MPCNL), ultra-mini-PCNL (UMP), micro-PCNL, mini-micro-PCNL, and super-mini-PCNL (SMP). However, despite its minimally-invasive nature, its potential superiority in terms of safety and efficacy when compared to conventional PCNL is still under debate. The aim of this review is to summarise different available modalities of miniaturized PCNL, details of instruments involved, and their corresponding safety and efficacy. In particular, this article highlights the role of the SMP and our experience with this novel technique in management of urolithiasis. Overall, miniaturized PCNL techniques appear to be safe and effective alternatives to conventional PCNL for both adult and pediatric patients. Well-designed, randomized studies are required to further investigate and identify specific roles of miniaturized PCNL techniques before considering them as standard rather than alternative procedures to conventional PCNL.
作者简介: 1 Both authors contributed equally to this work.
引用本文:
. [J]. Asian Journal of Urology, 2018, 5(4): 295-302.
Guohua Zeng,Wei Zhu,Wayne Lam. Miniaturised percutaneous nephrolithotomy: Its role in the treatment of urolithiasis and our experience. Asian Journal of Urology, 2018, 5(4): 295-302.
Table 1 Current nomenclature of mini-PCNL techniques.
First-generation SMP (n = 9)
New-generation SMP (n = 38)
p value
Basic RPP (mmHg, mean ± SD)
8.9 ± 4.0
10.7 ± 3.4
0.178
Intraoperative RPP (mmHg, mean ± SD)
14.0 ± 5.6
21.3 ± 10.2
<0.001
Number of patients who had one episode of RPP ≥ 30 mmHg
7/9
30/38
0.938
Accumulated time of RPP ≥ 30 mmHg (s, mean ± SD)
14.3 ± 18.0
92.3 ± 88.4
<0.001
Table 2 Character of RPP during the first- or new-generation SMP [35].
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