Ji J. et al., 2025: Effects of micro-channel negative pressure sheath percutaneous nephrolithotomy versus extracorporeal shock wave lithotripsy for renal stones: risk factors for postoperative complications.

Ji J, Wang X, Xiao J.
Am J Transl Res. 2025 Nov 15;17(11):8815-8827. doi: 10.62347/WPSF5538

Abstract

Objective: To compare the effects of micro-channel negative pressure sheath percutaneous nephrolithotomy (mPCNL) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of renal stones and analyze risk factors for postoperative complications.

Methods: A retrospective analysis was conducted on 120 patients with renal stones treated at Beijing Friendship Hospital from January 2023 to December 2024. Patients were divided into two groups: control (ESWL, n=60) and observation (mPCNL, n=60). Clinical efficacy, renal injury markers, inflammatory factors, oxidative stress markers, quality of life, and complications were compared. Risk factors for complications were assessed by dividing patients into good and poor outcome groups based on complications within 30 days post-surgery.

Results: The observation group showed a significantly higher clinical efficacy rate than the control group (P<0.05). Renal injury and inflammatory markers increased 24 hours post-surgery in both groups, with the control group showing a more significant rise. Oxidative stress markers also showed a greater change in the control group (P<0.05). At 30 days post-surgery, quality of life improved more significantly in the observation group (P<0.05). The total complication rate was lower in the observation group (P<0.05). Multivariate analysis identified age, surgical method, stone diameter, catheter indwelling time, renal insufficiency, and diabetes as independent risk factors for complications (all P<0.05).

Conclusion: mPCNL was more effective than ESWL for renal stones treatment, with fewer complications and greater quality of life improvement. Age, surgical method, and stone diameter were independent risk factors for postoperative complications.

Comment Peter Alken

Reading this article makes me feel slightly uneasy. Principally the paper offers a lot of information. However, it is a retrospective study with unclear selection bias. 120 patients seen in 2 years is a small number.  Inclusion criterium was “Renal stones diagnosed by imaging and clinical evaluation, unilateral in nature” which is rather unspecific. Stone size was  2.5 cm  in 51.67 % and  41.67 % of the of the EWSL and PNL cases resp. which is not a good indication for ESWL.  Postoperative catheter indwelling time was ≥ 5 days in 46.67 % and 40% of the ESWL and PNL cases resp.  Why?

Perhaps my unease while reading this article stems simply from the fact that the authors have to write in a foreign language and think differently than a Western European reader. However, there are several inconsistencies that could typically have been generated by a poorly trained large language model like chatGPT or similar. I do not recommend reading it and think it is enough if just one person reads this article. For publication in the open-access journal American Journal of Translational Research, $1880 is generally required.

Peter Alken