Tri Hanprasertpong¹, Wongtiti Titiroongruang¹, Wattanachai Ungjaroenwathana¹

Objective: To compare stone free rate results from modified ultra-mini-percutaneous nephrolithotomy (mUMP) and conventional tubeless percutaneous nephrolithotomy (tPCNL).

Materials and Methods: The present study was a retrospective cohort study in renal stone patients admitted at Sunpasitthiprasong Hospital, Thailand, between 2013 and 2021 by excluding patients with pregnancy, uncorrectable coagulopathy, and active urinary tract infection. Data was collected from 317 patients that matched criteria of patient characteristics, stone characteristics, intraoperative data, and surgical outcomes. The primary and secondary outcome were analyzed by assessing the stone-free rate immediately post-operative, within 24 hours, and at four weeks follow-up. This included perioperative data and subgroup analysis based on stone size of 20 mm or less and more than 20 mm.

Results: The group was separated into tPCNL with 184 patients and mUMP with 133 patients. The results of primary and secondary outcome of stone-free rates immediately post-operative and at follow up in tPCNL was 74.5% and 75% and in mUMP was 85% and 86.5%. When comparing stone size in subgroups of 20 mm or less, it was 100% in tPCNL and 95.5% in mUMP, however in the group of more than 20 mm stone, tPCNL was 71.3% and mUMP was 68.9%.

Conclusion: The mUMP is a safe and effective treatment compared to conventional tPCNL for stones of 20 mm or less. Furthermore, the mUMP group patients experienced less post-operative pain, shorter hospital stays, reduction of blood transfusions needs, lower irrigation volume required, and less postoperative urinary tract infection.

Received 27 February 2024 | Revised 25 March 2024 | Accepted 14 May 2024

DOI: 10.35755/jmedassocthai.2024.12.1002-1007-00776