ABSTRACT
Background: Kidney staghorn stones pose a significant challenge in urological practice due to their size and complexity. Traditional treatment methods often involve invasive procedures with prolonged recovery times and potential complications. In this research, we intended to compare efficiency and safety of Mini Endoscopic Combined Intrarenal Surgery (Mini-ECIRS) and Multitract Minimally Invasive Percutaneous Nephrolithotomy (Mini-PCNL) in management of kidney staghorn stones.
Aim: The purpose of the research was to assess outcomes of Mini-ECIRS and Mini-PCNL in rapports of stone clearance, operative time, hospital stay, and problem rates among a cohort of 100 patients treated at Sir Ganga Ram Hospital, Lahore.
Methods: A retrospective analysis was led on 100 individuals having kidney staghorn stones who experienced either Mini-ECIRS or Mini-PCNL between October 2022 and October 2023 at Sir Ganga Ram Hospital, Lahore. Patient demographics, stone characteristics, operative details, and postoperative results were recorded and analyzed. Mini-ECIRS involved use of a miniature flexible ureteroscope and holmium laser lithotripsy, while Mini-PCNL utilized a multitract approach with smaller diameter percutaneous tracts.
Results: Stone clearance rates were comparable between Mini-ECIRS and Mini-PCNL groups, with 92% and 88% of patients achieving complete stone clearance, respectively. The average operative time for Mini-ECIRS was 75 minutes (SD ± 10) compared to 90 minutes (SD ± 15) for Mini-PCNL. Hospital stay was shorter for Mini-ECIRS patients (mean 2.5 days, SD ± 0.5) compared to Mini-PCNL patients (mean 3.2 days, SD ± 0.7). Complication rates were similar between two sets, with minor problems observed in 12% of Mini-ECIRS cases and 14% of Mini-PCNL cases.
Conclusion: Both Mini-ECIRS and Mini-PCNL are actual and safe minimally invasive techniques for management of kidney staghorn stones. Mini-ECIRS offers advantages such as shorter operative time and hospital stay, making it a favorable option for selected patients. However, choice among those techniques must be created on individual patient aspects and surgeon expertise.
Keywords: Kidney staghorn stones, Mini Endoscopic Combined Intrarenal Surgery (Mini-ECIRS), Multitract Minimally Invasive Percutaneous Nephrolithotomy (Mini-PCNL), stone clearance, operative time, hospital stay, complications.