Minipercutaneous Nephrolithotomy as an Alternative to Standard PCNL for Selected Renal Stones ≤ 2 cm: Real-World Retrospective Study.

BACKGROUND

The comparative efficacy and safety of minipercutaneous nephrolithotomy (mPCNL) versus standard percutaneous nephrolithotomy (PCNL) in selected patients with renal stones ≤ 2 cm remain insufficiently defined.

METHODS

This retrospective cohort study included 146 adult patients with single renal stones ≤ 2 cm who underwent PCNL between May 2023 and May 2025. The patients were assigned to the mPCNL group (≤14 Fr, n = 72) or standard PCNL group (22-24 Fr, n = 74). All procedures were performed using holmium: Yttrium aluminum garnet (YAG) laser lithotripsy. The primary outcome was the single-session stone-free rate assessed by noncontrast computed tomography (CT) within 3 days postoperatively. Secondary outcomes included perioperative parameters,renal function indices (serum creatinine and cystatin C), inflammatory biomarkers (interleukin-6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP)) and postoperative complications.

RESULTS

The single-session stone-free rates were comparable between the mPCNL and standard PCNL groups (94.4% vs. 89.2%, p = 0.248). The mPCNL group showed significantly lower intraoperative blood loss, earlier ambulation and shorter hospital stay (all p < 0.001). Although inflammatory markers increased after surgery in both groups,the magnitude of increase in PCT and CRP was significantly lower in the mPCNL group (all p < 0.001). The overall complication rates were low and comparable between the groups (6.94% vs. 12.16%, p = 0.284).

CONCLUSIONS

In selected patients with renal stones ≤ 2 cm requiring percutaneous intervention,mPCNL provides similar stone clearance and short-term renal safety compared with standard PCNL whilst offering the advantages of reduced surgical trauma, attenuated postoperative inflammatory response and faster recovery.