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Minerva Urology and Nephrology 2021 April;73(2):187-95

DOI: 10.23736/S2724-6051.21.04185-0


language: English

Mini-percutaneous nephrolithotomy versus shock wave lithotripsy for the medium-sized renal stones

Xiaoshuai GAO 1, Xiao HU 1, Wei WANG 1, Jixiang CHEN 1, Tangqiang WEI 2, Xin WEI 1

1 Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, University of Sichuan, Chengdu, China; 2 Department of Urology, Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China

INTRODUCTION: The aim of this study was to assess the clinical outcomes of mini-percutaneous nephrolithotomy (Miniperc) and shock wave lithotripsy (SWL) for medium-sized renal stones.
EVIDENCE ACQUISITION: A literature search was performed in February 2020 using the Pubmed, Web of Science and Embase. The outcome measurements between two procedures were stone-free rates (SFR), complication rates, operative time, hospitalization stay time, re-treatment rate, auxiliary procedures rate and efficiency quotient. Results were pooled by Review Manager version 5.3 software.
EVIDENCE SYNTHESIS: Seven studies on 936 patients (N.=471 for SWL and N.=465 for Miniperc) were included. Miniperc was associated with a higher SFR (OR: 0.25; P<0.00001). In addition, we performed a subgroup analyses for pediatric renal stones and lower pole stones, pooled results also favored Miniperc for higher SFR. SWL was associated with higher auxiliary procedure (OR: 3.32; P<0.00001), higher re-treatment rate (OR: 19.19; P<0.00001) and lower EQ (OR: 0.18; P=0.0003) compared with Miniperc. Besides, SWL was associated with a lower complication rate (OR: 0.36; P=0.0001), shorter operative time (WMD: -34.01; P<0.00001), fluoroscopy time (WMD: -134.48; P<0.00001) and hospital time (WMD: -49.11; P<0.00001) compared with Miniperc.
CONCLUSIONS: Miniperc offers a significantly higher SFR, lower auxiliary procedure and re-treatment rate, but SWL was associated with fewer complications.

KEY WORDS: Nephrolithotomy, percutaneous; Kidney calculi; Urology

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