Clinical Comparison of Mini-Percutaneous Nephrolithotomy with Vacuum Cleaner Effect or with a Vacuum-Assisted Access Sheath: A Single-Center Experience

Elena Lievore, Luca Boeri, Stefano Paolo Zanetti, Irene Fulgheri, Matteo Fontana, Matteo Turetti, Carolina Bebi, Francesco Botticelli, Andrea Gallioli, Fabrizio Longo, Roberto Brambilla, Mauro Campoleoni, Elisa De Lorenzis, Emanuele Montanari, Giancarlo Albo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare outcomes of two different miniaturized percutaneous nephrolithotomy (PCNL) techniques: minimally invasive PCNL (MIP) with the vacuum cleaner effect and vacuum-assisted mini-PCNL (vmPCNL). Materials and Methods: Data from 104 (66.7%) patients who underwent vmPCNL and 52 (33.3%) patients who underwent MIP at a single tertiary referral academic center between January 2016 and December 2019 were analyzed. Patient demographics and peri- and postoperative data were recorded, and propensity score matching was performed. Descriptive statistics and linear regression models were used to identify variables associated with operative time (OT) and patient effective dose. Logistic regression analyses were used to identify factors associated with infectious complications and stone-free (SF) status. Results: Patient demographics and stone characteristics were comparable between groups. vmPCNL was associated with shorter OT (p < 0.001), fluoroscopy time, and patient effective dose (4.2 mSv vs 7.9 mSv; p < 0.001). A higher rate of infectious complications was found in the MIP group (25.0% vs 7.7%, p < 0.01). Linear regression analysis showed that stone volume, multiple stones, and MIP procedure (all p values ≤0.02) were associated with longer OT. Similarly, OT and the MIP procedure (p ≤ 0.02) were associated with higher patient effective dose. Logistic regression analysis revealed that the stone volume, positive preoperative bladder urine culture, and MIP procedure (all p values ≤0.02) were associated with postoperative infectious complications. vmPCNL was not associated with the SF rate. Conclusions: Mini-PCNL performed with continuous active suction is associated with lower rates of infectious complications, shorter OT, and lower patient effective dose than MIP.

Original languageEnglish
Pages (from-to)601-608
Number of pages8
JournalJournal of Endourology
Volume35
Issue number5
DOIs
Publication statusPublished - May 2021

Keywords

  • infectious complications
  • percutaneous nephrolithotomy
  • radiation exposure
  • stone-free rate
  • vacuum-assisted percutaneous nephrolithotomy

ASJC Scopus subject areas

  • Urology

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