title: Small-calibre percutaneous nephrolithotomy (SC-PCNL). Therapeutic decision algorithm.
abstract: BACKGROUND
  The progressive reduction in the calibre of the tract in percutaneous kidney surgery to the point of miniaturisation has expanded its use to smaller stones that until now have been treated with extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS).
  
  
  OBJECTIVE
  To provide an update on the various techniques of small-calibre nephrolithotomy (SC-PCNL) analyse their efficacy, safety and indications and determine their degree of implantation at this time.
  
  
  METHODS
  We performed a review in PubMed of Spanish and English medical literature on the various techniques of SC-PCNL.
  
  
  RESULTS
  The use of SC-PCNL has reduced the morbidity associated with standard PCNL, particularly bleeding, and has enabled tubeless nephrolithotomy with greater safety. There are various techniques with blurred terminology (Miniperc, Microperc, Mini-microperc, Ultraminiperc), which differ in terms of gauge employed and in certain technical aspects that require their indications be specified. Currently, SC-PCNL competes with techniques that are less invasive than standard PCNL such as ESWL and the RIRS in treating small stones, but the role of SC-PCNL is still not sufficiently understood and continues to be the subject of debate.
  
  
  CONCLUSIONS
  The indications for PCNL are expanding to small stone sizes due to the miniaturisation of the technique. PCNL competes in this field with ESWL and RIRS. Larder studies are needed to establish the specific indications for PCNL in treating nephrolithiasis.
authors.affiliation: Servicio de Urología, Hospital Universitario Río Hortega. Valladolid, España. Electronic address: amonsesmero@gmail.com.
authors.forename: J H
authors.initials: JH
authors.lastname: Amón Sesmero
authors.affiliation: Servicio de Urología, Hospital Universitario Río Hortega. Valladolid, España.
authors.forename: M
authors.initials: M
authors.lastname: Cepeda Delgado
authors.affiliation: Servicio de Urología, Hospital Universitario Río Hortega. Valladolid, España.
authors.forename: B
authors.initials: B
authors.lastname: de la Cruz Martín
authors.affiliation: Servicio de Urología, Hospital Universitario Río Hortega. Valladolid, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Mainez Rodriguez
authors.affiliation: Servicio de Urología, Hospital Universitario Río Hortega. Valladolid, España.
authors.forename: D
authors.initials: D
authors.lastname: Alonso Fernández
authors.affiliation: Servicio de Urología, Hospital Universitario Río Hortega. Valladolid, España.
authors.forename: V
authors.initials: V
authors.lastname: Rodriguez Tesedo
authors.affiliation: Servicio de Urología, Hospital Universitario Virgen de la Nieves, Granada, España.
authors.forename: D A
authors.initials: DA
authors.lastname: Martín Way
authors.affiliation: Department of Urology, Wake Forest Baptist Medical Center , Winston Salem, North Carolina, EE. UU.
authors.forename: J
authors.initials: J
authors.lastname: Gutiérrez Aceves
mesh_terms: D000465:Algorithms; D000066491:Clinical Decision-Making; D004867:Equipment Design; D006801:Humans; D008866:Microsurgery; D000074642:Nephrolithotomy, Percutaneous / Q000295:instrumentation / Q000379:methods*
keywords: Micropercutaneous; Micropercutánea; Minipercutaneous; Minipercutánea; Nefrolitectomía percutánea; Percutaneous nephrolithotomy