228 320
Table 2 (
Continued
)
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
Yamaguchi 2011,
comparative study,
Global, 2007–2009
[27]
NA
18 Fr
NA
Harms: BL, BT
271 NA BL: 11 (4.1%)
BT: 3 (1.1%)
NA
NR
CROES database
BT rates differ slightly between
Tables 5 and 8 (after summing
dilatation methods). Data for BL
calculated from Table 8 (total of
both dilatation methods). Data
for BT are as stated in Table 5.
Factors predictive of bleeding
complications include sheath
size
24–26 Fr
1039
BL: 53 (5.1%)
BT: 50 (4.8%)
27–30 Fr
3533
BL: 306 (8.7%)
BT: 208 (5.9%)
32 Fr
371
BL: 33 (8.9%)
BT: 45 (12.1%)
Mishra 2011,
comparative study,
India, 2009–2010
[24]NA
mPNL 14–18Fr
PNL 24–28Fr
Benefits: SFR (at 1 mo)
Harms: CG, BL,
Secondary outcomes:
DHS, DP, analgesic
requirement
27 28 SFR: 26/27 (96)%
BL: 0.8 0.9%
Pelvic perforation: 1
Bleeding 0
Fever: 2
DP: 45.2 12.6 min
DHS: 3.2 0.8 d
AR (tramadol): 55.4 50 mg
TL: 21 (78%)
SFR: 28/28 (100%)
BL: 1.3 0.4%
Pelvic perforation: 2
Bleeding 4
Fever 4
DP: 31 16.6 min
DHS: 4.8 0.6 d
AR (tramadol): 70.2 52 mg
TL: 4 (14%)
0.49
0.0098
1
0.11
0.66
0.0008
<
0.00001
0.28
<
0.001
BL reported as percent drop in
hematocrit.
Energy source for stone
fragmentation:
Laser for mPNL (19/1)
Pneumatic for standard (22/0)
mPNL had similar SFR for 1–
2-cm kidney stones.
Despite longer operation
time, mPNL had shorter DHS
and higher tubeless rate
related to less bleeding
Knoll 2010, comparative
study, Germany,
2007–2009
[22]
NA
mPNL 18 Fr
PNL 26 Fr
Benefits: ISFR
Harms: BL, fever, VI
Secondary outcomes: DP,
Pain: VAS, AR, DHS
25 25 ISFR: 24/25 (96%)
BL: 1/25 (4%)
Fever: 3/25 (12%)
VI (perforation): 0 (0%)
DP: 59 29.1 [34–82] min
Pain, VAS: 3 3 [0–5]
AR (piritramide): 25 12 mg
DHS: 3.8 2.1 d
ISFR: 23/25 (92%)
BL: 2/25 (8%)
Fever: 5/25 (20%)
VI (perforation): 1 (4%)
DP: 49 21.7 [26–73] min
Pain, VAS: 4 3 [1–7]
AR (piritramide): 37 10 mg
DHS: 6.9 2.9 d
NR
NS
0.048
NS
0.021
Stones significantly larger
(
p
= 0.042) in PNL group.
mPNL was TL with thrombin-
matrix tract closure if
uncomplicated and stone-free.
Otherwise 16 Fr tube was
placed.
All PNL had 22 Fr tube. BL
reported as ‘‘prolonged
postoperative bleeding’’,
although no patients required
BT
Shorter hospital stay and less
postoperative pain may
support use of mPNL for
smaller and intermediate
stones. Lower stone burden
and TL fashion of mPNL, may
have influenced results
Giusti 2007,
comparative study,
Italy, 1999–2004
[11]NA
mPNL 14 Fr
PNL 30 Fr
Benefits: SFR
Harms: BL, BT
Secondary outcomes: DP,
pain: VAS, AR, DHS
Other outcomes: TRNA
40 67 mPNL 14 Fr
SFR: 31/40 (77.5%)
BL: 4.49 3.1%
BT: 0/40 (0%)
DP: 155.5 32.9 min
Pain VAS: 5.53 1.14
AR (substance NR): 73.8 50 mg
DHS: 3.05 1.69 d
TRNA: 12.31 4.65 d
PNL 30 Fr
SFR: 63/67 (94%)
BL: 6.31 4.29%
BT: 2/67 (2.9%)
DP: 106.6 24.4 min
Pain VAS: 6.36 1.67
AR: 88.1 78.5 mg
DHS: 5.07 2.15 d
TRNA: 17.67 4.7 d
NR
NR
BL reported as percent drop in
hematocrit. Analgesic substance
NR.SD for ages NR. Lack of
statistical calculations for even
important outcomes such as
SFR, despite conclusions being
drawn for this outcome
mPNL SFR and BL were lower
than for sPNL. TL sPNL was
superior in terms of reduced
pain, shorter hospital stay,
and higher SFR, while
showing similar complication
rates
Tubeless PNL 30 Fr
27
TL PNL 30 FR
SFR: 27/27 (100%)
BL: 5.18 3.63
BT: 1/27 (3.7%)
DP: 95.9 45.5 min
Pain VAS: 3.45 0.65
AR: 41.1 30.2 mg
DHS: 2.18 2.13 d
TRNA: 10.93 4.87 d
Miller 2014, case series,
UK, 2009–2013,
abstract
[32]NA
mPNL 16.5 Fr
NA
Benefits: ISFR, ICIRFR,
Harms: CG, BT, US, SP
Secondary outcomes:
DP, DHS
116 NA ISFR: 54 (46.5%)
ICIRFR: 79.4%
CG: 2 [BT] 3 (2.6%) + 2 [INF] 18 (16%)
BT: 3 (2.6%)
US: 15 (12.9%)
DP: 174 min
SP: 24 (20.7%): SWL 10 (8.6%), URS 9
(7.8%), PNL 5 (4.3%)
DHS: 3.9 d
NA
NR
Comparison of retrospectively
reviewed cases of mPNL and PNL
from CROES database, but no
comparison data or
p
values
included in the abstract
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
228