East Coast Malaysia mini percutaneous nephrolithotomy series: an effective and safe approach to treat renal stones

Objective: This paper aims to determine the safety and efficacy of mini percutaneous nephrolithotomy (PCNL) by evaluating the postoperative pain score, postoperative length of hospital stay, stone free-rate, perioperative blood loss, and changes in renal function in patients with nephrolithiasis. Materials and Methods: This retrospective cohort study involved patients who underwent mini PCNL at the Hospital Tengku Ampuan Afzan (HTAA), Pahang, Malaysia, from January 1st, 2019, until December 31st, 2023. Data are presented descriptively. Changes in haemoglobin and serum creatinine pre- and post- operative were compared using univariate analysis. Results: The cohort included a total of 50 patients who underwent mini PCNL at our centre. Ninety two percent of the cases had radiopaque stones with a median size of 1.57cm3. The total operative time was 143.7±32.16 minutes, access being established in 90% of cases via the intracostal route. Four patients (8%) had complications (two (4%) were sepsis-related). Postoperative pain was reported as mild and tolerable, with a median length of hospital stay of 2 days. The stone-free rate was 96%, and the haemoglobin drop was less than 1 g/dl (MD=-0.57 (95% CI: -0.77, -0.37), p < 0.001) following mini PCNL. There was no significant change in serum creatinine observed Conclusion: Our study determined that mini PCNL is a safe and efficacious treatment modality in the management of nephrolithiasis in this Malaysian cohort. The growing trend of mini PCNL in Malaysian urology reflects the advancements in surgical techniques and the commitment of healthcare professionals to provide the best possible care for the patients.