Complex kidney stones usually require multi-tract percutaneous nephrolithotomy (PCNL) to remove the stone completely. The aim of this study was to evaluate the clinical feasibility and safety of super multiple-tract (≥ 5 tracts) minimally invasive percutaneous nephrolithotomy (Mini-PCNL) in one stage for treating complex renal stones. From March 2019 to August 2023, the perioperative clinical data of 35 patients who underwent super multiple-tract Mini-PCNL for complex kidney stones in our institution were collected and analyzed, retrospectively. A total of 35 patients were included in this study. The mean stone size and volume were 78.9 ± 22.8 mm and 13792.4 ± 5509.3 mm3, respectively. The mean S.T.O.N.E. score was 10.8, including 21 patients (60.0%) with scores ≥ 11. The average Guy's stone score was 3.5. The mean number of percutaneous tracts was 6.3 (range, 5–13). The average surgery time and length of hospital stay were 149.8 min and 3.4 days, respectively. The mean serum creatinine level declined by 6.5 mol/L (P = 0.518) and the mean hemoglobin drop was 24.9 g/L (P < 0.001). The postoperative complication rate was 25.7%, including one case of severe complication (Clavien grade IV). The mean follow-up time was 3.5 months, and the average glomerular filtration rate declined by 1.1 ± 8.7 ml/min (P = 0.463). The stone free rate was 82.9% after one- stage super multiple-tract Mini-PCNL. When performed by experienced urologists, super multiple-tract Mini-PCNL for treating some complex renal stones in one stage is feasible and safe in enhancing the stone-free rate.
Zhu et al. (Thu,) studied this question.