Prospective Comparative Study of Mini PCNL and Standard PCNL for the Treatment of 1 to 2 Cm Lower Calyceal Renal Stone

Background: Urolithiasis remains one of the most common urological conditions, and several treatment options are available, ranging from non-invasive to minimally invasive techniques. Standard percutaneous nephrolithotomy (PCNL) and its miniaturized version (Mini-PCNL) are frequently employed. This study evaluates the safety, effectiveness, and practicality of Mini-PCNL in managing 1–2 cm lower calyceal renal stones. Methods: A prospective comparative study was carried out on 60 patients diagnosed with lower calyceal calculi. Participants were divided into two groups: Standard-PCNL (control group) and Mini-PCNL (study group). Key parameters assessed included operative time, peri- and postoperative complications, stone clearance rates, need for analgesics, hemoglobin drop, requirement of blood transfusion, and duration of hospitalization. Data were recorded in Microsoft Excel and analyzed using SPSS and Statistica software. Results: The Mini-PCNL group demonstrated a signicantly longer mean operative time (55.06 ± 5.02 min) compared with Standard-PCNL (39.06 ± 4.54 min; p < 0.0001). However, Mini-PCNL required less postoperative analgesia (35.0 ± 16.86 vs. 55.83 ± 27.60; p = 0.001) and showed a lower mean hemoglobin drop (0.55 ± 0.17 g/dL vs. 1.0 ± 0.32 g/dL; p = 0.0001). The stone-free rates were comparable between both groups (96.66% vs. 100%; p = 0.313). Complications were generally fewer in the Mini-PCNL group, though differences were not statistically signicant. Conclusion: Mini-PCNL achieves stone clearance rates comparable to Standard-PCNL for stones measuring 1–2 cm. Although it requires a longer operative time, Mini-PCNL is associated with reduced blood loss, lower analgesic requirement, and a trend toward shorter hospital stay, making it an effective and safe alternative for managing lower calyceal renal stones.