Comparative analysis between mini percutaneous nephrolithotomy and flexible ureterorenoscopy for the management of renal lithiasis.

OBJECTIVES

To describe and compare the effectiveness and complications in our center with mini-percutaneous nephrolithotomy (mini-PCNL) and flexible ureterorenoscopy (URS) techniques for kidney stones.

MATERIAL AND

METHODS

Retrospective study with patients aged 0-14 years undergoing lithotomy at our center from 2009-2024. Demographic variables, medical history, location, size, stone composition, stone-free rate, operative time, hospital stay, and early complications (Clavien-Madadi scale) are analyzed.

RESULTS

Twenty cases were obtained: 9 URS and 11 mini-PCNL. The mean age was 8 years (4.71-9.56) with 57.9% males. 42% presented some lithogenic factor (3 cystinuria, 2 hypercalciuria). No differences were found between URS and mini-PCNL groups (p> 0.05) in age, sex, location, size, medical history, composition, operative time [150 (110-250) vs 120 (70-243) min], hospital stay [1 (1-2) vs 1 (1-2) days], or double J stent placement. The stone-free rate was 45% for mini-PCNL and 30% for URS (p= 0.042). The complication rate was 66% for URS [3 cases of urinary tract infection (CM II), 3 stone migration (CM IIIa)]; and 18% for mini-PCNL [1 case of pain (CM II) and 1 stone migration (CM IIIa)], with statistically significant differences being found (p= 0.02, relative risk of complication or RR= 1.14).

CONCLUSIONS

Mini-PCNL is an effective and safe technique for the treatment of kidney stones, with higher stone-free rates than URS and fewer complications.