title: Prospective Outcomes of Ultra Mini Percutaneous Nephrolithotomy: A Consecutive Cohort Study.
abstract: OBJECTIVE
  Ultra mini percutaneous nephrolithotomy is a less invasive technique of percutaneous nephrolithotomy to treat small to medium sized calculi.
  
  
  METHODS
  We prospectively evaluated the outcomes of ultra mini percutaneous nephrolithotomy in a single surgeon, consecutive cohort study. Data on 94 patients who underwent ultra mini percutaneous nephrolithotomy were collected.
  
  
  RESULTS
  Mean ± SD calculus size was 15.9 ± 4.5 mm and mean density was 1,106 ± 167 HU. Access was achieved via the upper pole in 8 cases, interpolar in 33 and lower pole in 54. Mean operative time was 54 minutes (range 28 to 120). Mean hemoglobin loss was 0.81 gm/dl and the mean creatinine increase was 0.05 mg/dl. There were no transfusions or kidney injuries. Grade I and IIIb complications were observed in 4 and 1 patients, respectively. The most serious complication was a perinephric collection. Postoperatively oral analgesia was sufficient in 86 patients (91%). Mean length of stay was 38.2 ± 15.9 hours. Nephrostomy drainage was used in 13 patients while 7 (7%) required a stent for 1 week. Intraoperatively 99% of renal units were stone free (absence of detectable calculi) on fluoroscopy, and 74% and 81% were stone free on day 1 postoperative ultrasound and 1-month computerized tomography, respectively. The 10 to 20 mm stones showed less bleeding, shorter operative time and a significantly lower requirement for nephrostomy or a Double-J(®) stent.
  
  
  CONCLUSIONS
  Ultra mini percutaneous nephrolithotomy appears to be effective and safe with a short length of stay. It may be a valuable addition to the armamentarium to treat 10 to 20 mm calculi in patients who wish to avoid routine nephrostomy or stents. Randomized, controlled trials are required.
authors.affiliation: Department of Urology, Colchester Hospital University National Health Service Foundation Trust, Colchester, United Kingdom; Department of Urology, Samved Hospital (RS, JD), Ahmedabad, India.
authors.forename: Soumendra N
authors.initials: SN
authors.lastname: Datta
authors.affiliation: Department of Urology, Colchester Hospital University National Health Service Foundation Trust, Colchester, United Kingdom; Department of Urology, Samved Hospital (RS, JD), Ahmedabad, India.
authors.forename: Ronak
authors.initials: R
authors.lastname: Solanki
authors.affiliation: Department of Urology, Colchester Hospital University National Health Service Foundation Trust, Colchester, United Kingdom; Department of Urology, Samved Hospital (RS, JD), Ahmedabad, India. Electronic address: drjanakddesai@gmail.com.
authors.forename: Janak
authors.initials: J
authors.lastname: Desai
mesh_terms: D000698:Analgesia; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: kidney calculi; laser therapy; lithotripsy; minimally invasive surgical procedures; nephrostomy; percutaneous