Gao X. et al., 2021: Mini-percutaneous nephrolithotomy versus shock wave lithotripsy for the medium-sized renal stones.

Gao X, Hu X, Wang W, Chen J, Wei T, Wei X.
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, University of Sichuan, Chengdu, China.
Department of Urology, Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China.
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, University of Sichuan, Chengdu, China.

Abstract

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.

Minerva Urol Nephrol. 2021 Apr;73(2):187-195. doi: 10.23736/S2724-6051.21.04185-0. PMID: 34036766.