Comparison of Trifecta Analysis of Standard Versus Mini Percutaneous Nephrolithotomy in the Management of Urolithiasis

Hayat Abad Medical Complex, Peshawar180 enrolled

Overview

Introduction: Urolithiasis is a common urological condition, and percutaneous nephrolithotomy (PCNL) is a widely used treatment option. Trifecta analysis, which includes stone-free rate, reduced complications (Clavien- Dindo classification), and minimal need for auxiliary procedures, provides a standardized way to compare outcomes. This study evaluates the trifecta outcomes of standard PCNL and mini PCNL.

Methodology: This prospective cohort study was conducted at the department of urology, Institute of Kidney Diseases, Peshawar from Jan 2022 to March 2024. 180 consecutive individuals who were subjected to percutaneous nephrolithotomy (PCNL) were registered for the study. Patients were randomly assigned into two equal groups using a lottery method. Both the standard PCNL group and mini PCNL group consisted of 90 patients each. Patients who required a change in the planned surgical procedure were replaced with new participants from the sample frame. A structured proforma was filled out for all preoperative, perioperative, and postoperative variables in administration of trifecta, and the data was analyzed using SPSS. An assessment was done for predictive factors for the trifecta using logistic regression to calculate the odds ratio, confidence interval (CI), and p value.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

180

Conditions

Renal Stones Urolithiasis, Calcium Oxalate

Interventions

Mini PCNLPROCEDURE

90 Participants underwent MINI PCNL in MIN PCNL arm and 90 Participants underwent Standard PCNL in Standard PCNL arm.

Eligibility

Sex: ALLMin age: 16 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged between 16 and 65 years having renal stones exceeding 20 mm in diameter or having a density more than 1000 Hounsfield Units (HU) were included. Exclusion Criteria: * Patients with residual stones following prior PCNL or other endourological procedures or active, untreated urinary tract infections or sepsis or patients with deranged coagulation profiles, were excluded

Locations (1)

Institute of Kidney Disease.

Peshawar, KPK, Pakistan

Outcomes

Primary Outcomes

Stone free rates

This outcome measures that which modality provide better stone free rates. Mini or standard PCNL.

Time frame: up to 4 weeks on post follow up imaging i.e CT KUB without contrast

Post operative complications rate

To find which modality has got lesser number of complications. Mini or standard PCNL

Time frame: Up to 4 weeks days post operative period

Need of auxiliary Procedures

to find which modality require the need of auxiliary Procedures like ESWL, URS, or Re DJS stenting.

Time frame: Up to 4 weeks post operatively

Data from ClinicalTrials.gov

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