Introduction

We performed a prospective randomized comparison among PerCutaNeous Lithotripsy (PCNL), MiniPerc (MP) and UltraMiniPerc (UMP) for lower calyceal stones between 1 and 2 cm to evaluate the efficacy and the safety of these procedures

Methods

Methods: Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were_x000D_ _x000D_ enrolled in this multicentric study. Exclusion criteria were the presence of coagulation impairments, age less than 18 or more_x000D_ _x000D_ then 75, presence of acute infection, presence of cardiovascular or pulmonary comorbidities. Patients were randomized into three groups: Group A: patients treated with PCNL; Group B: patients treated with MP; Group C: patients treated with UMP. Patients were controlled with abdomen X ray and CT scan after 3 months. A negative X ray  or an asymptomatic patients with stone fragments less than 3 mm big. and a negative urinary colture  were the criteria to assess the stone-free status. A statistical analysis was carried out to asses patients data, success and complications rates, re-treatment rate and need for auxiliary treatment.

Results

Results: Between January 2014 and June 2016, 132 consecutive patients were enrolled in this study. 44 pts for the group A, 47 for group B and 41 for group C. The mean stone size was 16.38 mm. in g roup A,  17.82 mm. in Group B and 15.23 mm. in Group C (p=0.34). The overall stone free rate was 86.3% for group A, 82.9% for group B and 78.0 % for group C. The retreatment rate was significantly higher in group C compared to the other two groups, 12.1% (p<0.05). The auxiliary  procedure rate was comparable for group A and B and C (p>0.05).  The complication rate was 13.6%, 4.2% and 2.4% respectively for group A, B and C.

Conclusions

Conclusions: PCNL and MP were more effective than UMP to obtain a better stone free rate. Auxiliary and re-treatment rate were similar. On the other hand for such this kind of stones PCNL had more complications. MP and UMP find a better indication in stones less than 1.5 cm in size.

Funding

none