dc.contributor.author | Zeng, Guohua | |
dc.contributor.author | Cai, Chao | |
dc.contributor.author | Duan, Xianzhong | |
dc.contributor.author | Xun, Xu | |
dc.contributor.author | Mao, Houping | |
dc.contributor.author | Li, Xuedong | |
dc.contributor.author | Nie, Yong | |
dc.contributor.author | Xie, Jianjun | |
dc.contributor.author | Li, Jiongming | |
dc.contributor.author | Lu, Jun | |
dc.contributor.author | Zou, Xiaofeng | |
dc.contributor.author | Mok, Jianfeng | |
dc.contributor.author | Li, Chengyang | |
dc.contributor.author | Li, Jianzhong | |
dc.contributor.author | Wang, Weiguo | |
dc.contributor.author | Yu, Yonggang | |
dc.contributor.author | Fei, Xiang | |
dc.contributor.author | Gu, Xianen | |
dc.contributor.author | Chen, Jianhui | |
dc.contributor.author | Kong, Xiangbo | |
dc.contributor.author | Pan, Jian | |
dc.contributor.author | Zhu, Wei | |
dc.contributor.author | Zhao, Zhijian | |
dc.contributor.author | Wu, Wenqi | |
dc.contributor.author | Sun, Hongling | |
dc.contributor.author | Liu, Yongda | |
dc.contributor.author | de la Rosette, Jean J. M. C. H. | |
dc.date.accessioned | 2021-01-15T08:10:12Z | |
dc.date.available | 2021-01-15T08:10:12Z | |
dc.date.issued | 2021 | en_US |
dc.identifier.citation | Zeng, G., Cai, C., Duan, X., Xun, X., Mao, H., Li, X. ... de la Rosette, J. J. M. C. H. (2021). Mini percutaneous nephrolithotomy is a noninferior modality to standard percutaneous nephrolithotomy for the management of 20-40 mm renal calculi: A Multicenter randomized controlled trial. European Urology, 79(1), 114-121. https://dx.doi.org/10.1016/j.eururo.2020.09.026 | en_US |
dc.identifier.issn | 0302-2838 | |
dc.identifier.issn | 1873-7560 | |
dc.identifier.uri | https://dx.doi.org/10.1016/j.eururo.2020.09.026 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12511/6257 | |
dc.description.abstract | Background: High quality of evidence comparing mini percutaneous nephrolithotomy (mPNL) with standard percutaneous nephrolithotomy (sPNL) for the treatment of larger-sized renal stones is lacking. Objective: To compare the efficacy and safety of mPNL and sPNL for the treatment of 20–40 mm renal stones. Design, setting, and participants: A parallel, open-label, and noninferior randomized controlled trial was performed at 20 Chinese centers (2016–2019). The inclusion criteria were patients 18–70 yr old, with normal renal function, and 20–40 mm renal stones. Intervention: Percutaneous nephrolithotomy PNL was performed using either 18 F or 24 F percutaneous nephrostomy tracts. Outcome measurements and statistical analysis: The primary outcome was the one-session stone-free rate (SFR). The secondary outcomes included operating time, visual analog pain scale (VAS) score, blood loss, complications as per the Clavien-Dindo grading system, and length of hospitalization. Results and limitations: The 1980 intention-to-treat patients were randomized. The mPNL group achieved a noninferior one-session SFR to the sPNL group by the one-side noninferiority test (0.5% [difference], p < 0.001). The transfusion and embolization rates were comparable; however, the sPNL group had a higher hemoglobin drop (5.2 g/l, p < 0.001). The sPNL yielded shorter operating time (–2.2 min, p = 0.008) but a higher VAS score (0.8, p < 0.001). Patients in the sPNL group also had longer hospitalization (0.6 d, p < 0.001). There was no statistically significant difference in fever or urosepsis occurrences. The study's main limitation was that only 18F or 24F tract sizes were used. Conclusions: Mini mPNL achieves noninferior SFR outcomes to sPNL, but with reduced bleeding, less postoperative pain, and shorter hospitalization. Patient summary: We evaluated the surgical outcomes of percutaneous nephrolithotomy using two different sizes of nephrostomy tracts in a large population. We found that the smaller tract might be a sensible alternative for patients with 20–40 mm renal stones. This multicenter, parallel, open-label, and noninferior randomized controlled trial showed that mini percutaneous nephrolithotomy achieved noninferior stone-free rate with advantages of reduced blood loss, less postoperative pain, and shorter hospitalization. Mini percutaneous nephrolithotomy should be considered a sensible alternative treatment of 20–40 mm renal stones. | en_US |
dc.description.sponsorship | grants from high-level development funding of Guangzhou Medical University | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Elsevier | en_US |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.subject | Mini | en_US |
dc.subject | Percutaneous Nephrolithotomy | en_US |
dc.subject | Standard | en_US |
dc.subject | Renal Stone | en_US |
dc.subject | Randomized Controlled Trial | en_US |
dc.title | Mini percutaneous nephrolithotomy is a noninferior modality to standard percutaneous nephrolithotomy for the management of 20-40 mm renal calculi: A Multicenter randomized controlled trial | en_US |
dc.type | article | en_US |
dc.relation.ispartof | European Urology | en_US |
dc.department | İstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı | en_US |
dc.authorid | 0000-0002-6308-1763 | en_US |
dc.identifier.volume | 79 | en_US |
dc.identifier.issue | 1 | en_US |
dc.identifier.startpage | 114 | en_US |
dc.identifier.endpage | 121 | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.identifier.doi | 10.1016/j.eururo.2020.09.026 | en_US |
dc.identifier.wosquality | Q1 | en_US |
dc.identifier.scopusquality | Q1 | en_US |