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Minipercutaneous nephrolithotomy and retrograde intrarenal surgery in the treatment of kidney stones: a meta-analysis based on a systematic review of the literature
DOI: https://dx.doi.org/10.18565/urology.2025.1.125-135
Guliev B.G., Andrianov A.A., Agagyulov M.U. Talyshinsky A.E., Fundament A.S.
1) Department of Urology (Head of Department – prof. Komyakov B.K.), of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia; 2) Center of Urology with robot-assisted surgery of City Mariinsky hospital (Chief – Reutsky I.A.), Saint Petersburg, Russia
Mini-percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are increasingly used to treat kidney stones. There is still debate in the literature regarding the efficiency and safety of these surgical procedures.
Aim. To carry out a systematic review of the results of mini-PCNL and RIRS.
A search of publications in the PubMed, Scopus, and Web of Science databases for the past 10 years was carried out to identify all studies that compared the results of mini-PCNL and RIRS. The following parameters were assessed: number and age of patients, stone size, presence of a lower-pole stone, duration of the procedure, complications according to the Clavien-Dindo classification, efficiency of the procedure, and length of hospital stay.
A total of 21 publications with comparative analyze of various variables for mini-PCNL and RIRS for kidney stones larger than 10 mm were found. The difference in the duration of the procedure between mini-PCNL and RIRS was 2.34 min, in the length of hospital stay 1.62 days. The relative risk (RR) of developing complications according to Clavien-Dindo grades I-III during mini-PCNL compared to RIRS was 1.16 (95% CI 0.88-1.53, p=0.2929), and the probability of SFR was 1.08 (95% CI 1.05-1.12).
The analysis showed that RIRS is associated with a shorter duration of procedure and length of hospital stay compared to mini-PCNL. The results were statistically significant regardless of stone size. For stones larger than 15 mm, mini-PCNL provides a slight advantage in efficiency compared to RIRS, and for stones larger than 25 mm, mini-PCNL is more preferable than RIRS, although the results do not differ significantly.
Aim. To carry out a systematic review of the results of mini-PCNL and RIRS.
A search of publications in the PubMed, Scopus, and Web of Science databases for the past 10 years was carried out to identify all studies that compared the results of mini-PCNL and RIRS. The following parameters were assessed: number and age of patients, stone size, presence of a lower-pole stone, duration of the procedure, complications according to the Clavien-Dindo classification, efficiency of the procedure, and length of hospital stay.
A total of 21 publications with comparative analyze of various variables for mini-PCNL and RIRS for kidney stones larger than 10 mm were found. The difference in the duration of the procedure between mini-PCNL and RIRS was 2.34 min, in the length of hospital stay 1.62 days. The relative risk (RR) of developing complications according to Clavien-Dindo grades I-III during mini-PCNL compared to RIRS was 1.16 (95% CI 0.88-1.53, p=0.2929), and the probability of SFR was 1.08 (95% CI 1.05-1.12).
The analysis showed that RIRS is associated with a shorter duration of procedure and length of hospital stay compared to mini-PCNL. The results were statistically significant regardless of stone size. For stones larger than 15 mm, mini-PCNL provides a slight advantage in efficiency compared to RIRS, and for stones larger than 25 mm, mini-PCNL is more preferable than RIRS, although the results do not differ significantly.
About the Autors
Corresponding author: B.G. Guliev – Ph.D., MD, professor, Head of Center of Urology with robot-assisted surgery of City Mariinsky hospital, Saint Petersburg, Russia; e-mail: gulievbg@mail.ru
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