The following is a summary of “Comparison of the efficacy and safety of mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones in overweight or obese patients: a systematic review and meta-analysis,” published in the November 2024 issue of Urology by Qiu et al. 

Researchers conducted a retrospective study to analyze the efficacy and safety of mini percutaneous nephrolithotomy (MiniPCNL) and retrograde intrarenal surgery (RIRS) for kidney stones in patients with obesity. 

They conducted a comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, and CNKI for controlled trials on MiniPCNL and RIRS for treating kidney stones in patients with overweight or obesity, covering records up to September 2023. Data were analyzed using Review Manager 5.4 software. 

The results showed that MiniPCNL had higher overall complications, grade I complications, length of hospital stay (LOS), and both first and final stone-free rates (SFR) in patients with obese, with no significant differences in operative time (OT), hemoglobin drop, or grade II complications. In patients with stones >2 cm, MiniPCNL had more complications, higher final SFR, and longer LOS, with no difference in grade II complications. MiniPCNL in the prone position showed higher final SFR, less OT, and hemoglobin drop, with no significant differences in complications or LOS. Sheaths >14 F increased complications, final SFR, and LOS. In the MiniPCNL subgroup aged ≤50 years, first and final SFR were higher, with shorter OT, while in those >50 years, OT, LOS, and hemoglobin drop were greater, with no difference in overall complications. 

The study concluded that MiniPCNL in obese patients had higher initial and final SFR, fewer procedures, but more postoperative complications and LOS compared to RIRS. Similar results were seen in patients with stones >2 cm and age ≤50 years. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01588-4