Suction mini-percutaneous nephrolithotomy versus standard percutaneous nephrolithotomy for the management of 2–4 cm kidney stones: study protocol for an international, multicenter, parallel-group, noninferiority, randomized controlled trial - Scorecard - MDSpire
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Suction mini-percutaneous nephrolithotomy versus standard percutaneous nephrolithotomy for the management of 2–4 cm kidney stones: study protocol for an international, multicenter, parallel-group, noninferiority, randomized controlled trial
Clinical Scorecard: Comparison of Suction Mini-Percutaneous Nephrolithotomy and Standard Percutaneous Nephrolithotomy for Treating 2–4 cm Renal Stones
At a Glance
Category
Detail
Condition
2–4 cm renal (kidney) stones
Key Mechanisms
Percutaneous nephrolithotomy (PCNL) removes kidney stones via a tract; suction mini-PCNL uses a smaller tract with suction to improve fragment removal and maintain low intrarenal pressure
Target Population
Adults aged 18–70 years with 2–4 cm kidney stones, ASA score 1–2, no anatomical abnormalities or untreated UTI
Care Setting
Multicenter international urological institutes with experienced surgeons
Key Highlights
Standard PCNL is first-line for kidney stones >2 cm but associated with tract-related complications.
Mini-PCNL uses smaller tract to reduce complications but may prolong operative time and increase intrarenal pressure.
Suction mini-PCNL aims to combine benefits by enhancing stone fragment removal and reducing infection risk.
Guideline-Based Recommendations
Diagnosis
Confirm kidney stones measuring 2–4 cm by non-contrast CT scan.
Management
Use PCNL as first-line treatment for stones >2 cm.
Consider suction mini-PCNL as a potentially noninferior alternative to standard PCNL for 2–4 cm stones.
Monitoring & Follow-up
Assess immediate postoperative stone-free rate (SFR) via CT scan.
Evaluate final SFR at 1 month postoperatively.
Monitor operative time, length of hospital stay, postoperative complications, and quality of life.
Risks
Tract-related complications affecting renal parenchyma and blood vessels with standard PCNL.
Potential for increased intrarenal pressure and infectious complications if irrigation drainage is insufficient in mini-PCNL.
Patient & Prescribing Data
Adults 18–70 years with 2–4 cm renal stones, ASA 1–2, no anatomical abnormalities or untreated UTI.
Suction mini-PCNL hypothesized to be noninferior to standard PCNL in stone-free rates and operative time, with potential benefits of reduced complications.
Clinical Best Practices
Ensure surgeons have significant experience with both suction mini-PCNL and standard PCNL (≥100 cases/year).
Use stratified randomization and blinding of patients and outcome assessors in clinical trials.
Obtain informed consent detailing benefits and risks of both PCNL techniques.
Follow standardized operative protocols and postoperative assessment procedures.
by Wen Zhong, Kehua Jiang, Xuepei Zhang, Chi Ho Leung, Wei Zhu, Zhanping Xu, Guofu Pang, Zhongyi Sun, Fan Cheng, Jin Li, Jie Chen, Yuanwei Li, Houmeng Yang, Shulian Chen, Chuanxun Wu, Rui Jia, Jin Zhu, Jorge Gutierrez-Aceves, Emanuele Montanari, Shabir Almousawi, Iliya Saltirov, Marcin Popiolek, Albert Aquino, Giorgio Mazzon, Simon Choong, Haibo Xi, Steffi Kar Kei Yuen, Guohua Zeng
