RESUMO
Background Renal calculi therapy has advanced significantly in recent years, with mini-percutaneous nephrolithotomy (PCNL) emerging as a minimally invasive treatment modality. Mini-PCNL has been subjected to several modifications to achieve the best possible outcomes and reduce morbidity. This study aimed to compare the efficacy and safety of Swiss LithoClast Trilogy™ and pneumatic Swiss LithoClast™ in managing renal stones with mini-PCNL. Methodology This descriptive retrospective study was conducted at the Department of Urology, Lady Reading Hospital, from January 1, 2023, to December 31, 2023. A record of male and female patients aged more than 18 years who underwent mini-PCNL for renal stones was retrieved. The following two groups of patients were created: group A (n = 25) mini-PCNL with Swiss LithoClast Trilogy™ and group B (n = 26) mini-PCNL with pneumatic Swiss LithoClast™. The efficacy and safety profile of both groups was compared. Results A total of 51 patients were enrolled, with 25 in group A and 26 in group B. Groups A and B had mean ages of 45.2 and 47.5 years, respectively. Male participants outnumbered females in both groups, 72% (n = 18) in group A and 77% (n = 20) in group B. Group A had a mean stone size of 15.8 mm, and group B had a mean stone size of 16.5 mm. Stone-free rate on postoperative day one was 88% (n = 22) in group A and 84.6% (n = 22) in group B, with no statistically significant difference (p > 0.05). At the end of three months, 96% of participants in group A and 84.6% of patients in group B were found to be free of stones, and the difference between the two groups was not statistically significant (p > 0.05). Intraoperative hemorrhage occurred in 12% (n = 3) of group A and 15.4% (n = 4) of group B patients, with no significant difference (p > 0.05). Conclusions There were no significant differences in stone-free rates, complication rates, or intraoperative/postoperative complications between mini-PCNL with Swiss LithoClast Trilogy™ or Pneumatic Swiss LithoClast™.
RESUMO
Objective The objective of this study was to compare the STONE score (Size of the stone, Topography or location, degree of Obstruction of the urinary system, Number of stones, and Evaluation of Hounsfield units), Guy's stone score (GSS), Clinical Research Office of the Endourological Society (CROES) nomogram, and Seoul National University Renal Stone Complexity Score (RSCS) in prognosticating multiple tract mini-percutaneous nephrolithotomy (mPCNL) outcome. Methodology This descriptive retrospective analysis was carried out at the Urology Department, Lady Reading Hospital, Peshawar, Pakistan. Male and female patients in the age range of 18-70 years who underwent multiple tract mPCNL for renal stones from July 1, 2021, to June 30, 2023, were included in the analysis. Results A total of 110 patients were registered. Stone-free status (SFS) was achieved in 78.2% (n=86), and complications were observed in 13.6% (n=15) patients. The odds ratio for STONE score, GSS, CROES scoring system, and RSCS for predicting the SFS was 7.093 (95%CI 2.40-20.89), 9.333 (95%CI 2.92-29.81), 11.70 (95%CI 2.56-53.38) and 3.450 (95%CI 1.25-9.53), respectively. Conclusion Multiple tract mPCNL is a safe and effective technique for the management of renal stones, producing a high stone-free rate. This study demonstrated adequate efficacy and dependability of the four scoring systems in predicting SFS.
