227 320
Table 2 – Outcomes for all the studies included
Study ID, design,
country, recruitment period
Subgroups
(of mPNL group)
Intervention
Comparator
Outcomes
measured
n
at baseline
Outcomes
Reported
p
v
alues
Notes
Summary
Int Com
Int
Com
Tepeler 2014, RCT,
Turkey, 2012–2013
[28]NA
m
PNL 4.8 Fr
PNL 30 Fr
Benefits: ISFR
Harms: CG, BL
Secondary
outcomes: DP, DHS
Other: intrarenal
pelvic pressure
10 10 ISFR: 8 (80%)
CG 1: 1 (10%)
BL: 1.8% 0.8% (0.9–3.2%)
DP: 36.5 14.2 (20–60) min
DHS: 1.1 0.3 (1–2) d
IPP: 30.3 3.9 mm Hg
ISFR: 9 (90%)
CG 3a: 1 (10%)
BL: 3.5% 1.5% (1.2–6.1%)
DP: 49 9.8 (32–65) min
DHS: 2 0.5 (1–3) d
IPP: 20.1 3.1 mm Hg
1
0.004
0.034
0.001
<
0.0001
BL reported as percent drop in
hematocrit
m
PNL vs PNL showed no ISFR
benefit, although BL and DP
were lower. IPP was higher in
the
m
PNL group
Cheng 2010, RCT,
China, 2004–2007
[19]
Total
Staghorn stones (SS)
Simple renal pelvic
stones (SRPS)
Multiple calyceal
stones (MCS)
mPNL 16 Fr
PNL 24 Fr
Benefits: ISFR
Harms: CG, BL
Secondary
outcomes: DHS,
DP, analgesic
requirement
72
18
27
27
115
29
46
40
BL: 0.53 0.79 g/dL
BT: 1 (1.4%)
Pneumothorax: 1 (1.4%)
Urine leakage: 0 (0%)
DHS: 7.3 (6–12) d
AR (pethidine): 88.7 40.6 mg
VAS (1–2 d)
SFR for:
SS: 13/18 (72.2%)
SRPS: 25/27 (92.6%)
MCS: 23/27 (85.2%)
DP for:
SS: 134.4 19.7 min
SRPS: 89.4 21.5 min
MCS: 113.9 20.3 min
BL: 0.97 1.42 g/dL
BT: 12 (10.4%)
Pneumothorax: 0
Urine leakage: 2 (1.7%)
DHS: 7.5 (6–15) d
AR (pethidine): 94.3 37.2 mg
VAS (1–2 d)
SFR for:
SS: 22/29 (75.9%)
SRPS: 40/46 (91.3%)
MCS: 28/40 (70.0%)
DP for:
SS: 118.9 21.5 min
SRPS: 77 17.6 min
MCS: 101.2 19.1 min
<
0.05
<
0.05
>
0.05
>
0.05
>
0.05
>
0.05
>
0.05
>
0.05
>
0.05
<
0.05
<
0.05
<
0.05
<
0.05
BL and need for BT were
lower in mPNL group,
however stones were not fully
comparable. mPNL results
most favorable for multiple
calyceal stones.
DP was longer in mPNL group.
Karakose 2014,
comparative study,
Turkey, 2011–2012
[21]NA
mPNL 22 Fr
Unclear – chi–
square test used
Harms: CG, BL, BT,
AP, SP
Secondary
outcomes: DP
Other outcomes:
preop vs postop
creatinine
15 NA CG 1: 1, CG 2: 0
Preop Hb: 14.3 1.5 [11.6–17] g/dl
Postop Hb: 13.7 1.7 [10.2–16.1] g/dl
BT (
n
): 0
AP (
n
): 4
SP (
n
): 0
DP: 102.8 30.0 [55–126] min
Reference group for statistical
analysis not stated
PNL 24 Fr
19
CG 1: 2, CG 2: 0
Preop Hb: 13.9 1.8 [9.10–17] g/dl
Postop Hb: 12.9 1.7 [9.6–15.3] g/dl
BT (
n
): 0
AP (
n
): 2
SP (
n
): 0
DP: 105.5 39.5 [75–210] min
PNL 26 Fr
26
CG 1: 1, CG 2: 2
Preop Hb: 14.7 1.4 [11.7–17] g/dl
Postop Hb: 12.3 2.1 [7.9–14.7] g/dl
BT (
n
): 2
AP (
n
): 0
SP (n): 0
DP: 103.7 40.5 [40–115] min
PNL 28 Fr
18
CG 1: 0, CG 2: 4
Preop Hb: 14.4 1.4 [11.6–16.9] g/dl
Postop Hb: 11.7 1.8 [8.5–14.1] g/dl
BT (
n
): 4
AP (
n
): 0
SP (
n
): 0
DP: 110.6 45.3 [70–240] min
PNL 30 Fr
32
CG 1: 3, CG 2: 7
Preop Hb: 14.2 1.6 [9.10–17] g/dl
Postop Hb: 10.4 1.8 [8.3–12.3] g/dl
BT (
n
): 7
AP (
n
): 2
SP (
n
): 0
DP: 108.1 48.6 [65–220] min
>
0.05
<
0.05
>
0.05
Xu 2014, comparative
study, China,
2011–2013
[26]
NA
mPNL 16 Fr
PNL 24 Fr
Benefits: ISFR
Harms: CG, BL
Secondary
outcomes: DP, DHS
Other outcomes:
volume of fluid
absorbed
37 34 ISFR: 29/37 (78%)
CG 2: 5 (13.3%)
BL: 7.4 3.5 g/l
DP: 115.4 13.5 min
DHS: 9.8 3.4 d
ISFR: 27/34 (79%)
CG: 5 (14.7%)
BL: 9.6 4.0 g/l
DP: 110.6 17.0 min
DHS: 9.3 3.0 d
0.915
1.000
0.015
0.188
0.573
Not randomized: selection of
technique based on joint
decision by surgeons and
patients. Stones in PNL group
significantly larger
BL was significantly lower in
mPNL group, however stones
treated were smaller.
E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 2 2 0 – 2 3 5
227