Non papillary mini-percutaneous nephrolithotomy: early experience

Purpose: This study aims to evaluate the non-papillary puncture for mini-PCNL in terms of safety and efficacy. Methods: A total number of 32 patients were subjected to mini-PCNL by the performance of non-papillary punctures over 6 months. One-step track dilation to 22 Fr took place in all cases. An 18 Fr nephroscope (Slender, Karl Storz GmbH, Germany) and an ultrasound lithotripter (Lithoclast Master, EMS S.A, Switzerland) with 9.9 Fr probe was used. Demographics and perioperative data are prospectively collected from an institutional board-approved database and the presented data were retrospectively collected. Results: The average cumulative stone size was 23.53 ± 6.6 mm. Mean operative time was 44.6 ± 13.44 min and primary stone-free rate after PCNL was 96% and 85.7% for single and multiple access, respectively. Second access was performed in seven cases, all of which had multiple stones. Mean hemoglobin drop was 1.23 ± 0.88 gr/dL. The patients stayed 2.56 ± 0.98 days in the hospital. Overall complication rate was 9.37%, without encountering any severe bleeding complication. Conclusion: Using non-papillary access for mini-PCNL did not result in significant blood loss and need for transfusions. The respective data were directly comparable to contemporary literature and the safety of mini-PCNL by a non-papillary approach could be advocated.