Comparison Between Mini Percutaneous Nephrolithotomy and Standard Percutaneous Nephrolithotomy in Management of Large Renal Stones, a Randomized Controlled Clinical Trial.

OBJECTIVES: to compare between mini PNL and the standard PNL in management of renal stones (20-40 mm) regarding operative time, fluoroscopy time, blood loss, stone free rate, and postoperative complications.

SUBJECTS AND METHODS: This prospective randomized comparative study was carried out on 93 patients divided into 2 groups: Group A included 44 patients who underwent standard PNL, whereas Group B included 49 patients who underwent mini PNL.

RESULTS: Standard PNL showed shorter operative time yet longer hospitalization, nephrostomy and catheterization time. The mean drop in hemoglobin level was significantly lower in the mini PNL group. In the first week postoperatively, stone-free rate was higher in the standard PNL group, but this was statistically insignificant. However, 4 weeks postoperatively, stone free rate was significantly higher in group A. The postoperative pain and the need for postoperative analgesia were significantly higher in standard PNL patients.

CONCLUSIONS: Standard PNL achieved higher stone free rate and shorter operative time while mini PNL had the advantage of shorter hospitalization time and lower incidence of pain and postoperative complications.