Results
perforations, intraoperative bleeding, chronic kidney disease, Blood loss, HTN, Postoperative pain
CHRONIC ILLNESSES, ISCHEMIC HEART DISEASE, BLOOD LOSS, DIABETES MELLITUS, HTN, INTRAOPERATIVE COMPLICATIONS, LEAKAGE, INTRAOPERATIVE BLEEDING
Eighty patients were prospectively randomized into two groups to undergo mini-PCNL (n = 40) or standard-PCNL (n = 40). Mean age 41.6 ± 12.1 years, males were 60% while females were 40%.Comparison of age, gender, BMI, and chronic illnesses showed no statistically significant difference between the two study groups with p-values > 0.05.There was no statistically significant difference between the treatment groups in preoperative values, and X-ray exposure time with p-values > 0.05. (Table 
Demographics dataCKD, chronic kidney disease; DM, diabetes mellitus; HTN, hypertensionIHD, ischemic heart disease
Stone characteristics and operative details of PCNLSingle Stone/ multi-calycealSingle stoneBig stone& Multiple calycealPatient positioningLocalization method: Triangulation guided with fluoroscopy and pre-op CT2218Supine401921Supine40Puncture siteSingle puncture: lower posterior calyxSecond puncture: middle calyx382373Stone disintegration equipment:Holmium Laser & Pneumatic1Double Jinsertion3Double JinsertionOperative time was less among standard-PCNL compared to mini-PCNL (72.1 ± 14.9 minutes versus 95 ± 17.9 minutes) with p-value 0.0001. This difference can be explained with the variety of cases in regard to size, multiplicity and the need to have a second puncture.Intraoperative Complications: Among mini-PCNL group, there was one patient that had collecting system perforation that was managed with insertion of double J stent, while patients’ undergone standard-PCNL, three of them had collecting system perforation, that was managed with insertion of double j stent. In the 4 patients the perforations regress spontaneously and leakage stopped in the second post-operative day.One patient among standard-PCNL had intraoperative bleeding, that showed decreased hemoglobin level (Hb) and hematocrit value, the anesthetist recommended and gave the blood transfusion.On the other hand, there was no intraoperative bleeding in mini-PCNL patients. Blood loss in terms of the (mean ± SD) change in Hb level on first postoperative day in mini-PCNL was (0.58 ± 0.64) gm/dl which was significantly lower (P < 0.05) when compared to standard-PCNL (1.64 ± 0.93) gm/dl.Postoperative pain was higher in standard-PCNL (7.5 ± 0.7) versus (5.7 ± 1.1) in mini-PCNL with p values 0.0001.The need for non-steroidal anti-inflammatory drugs was higher in standard-PCNL compared to mini-PCNL.Hospital stay was longer in standard-PCNL compared to mini-PCNL (3.4 +/- 1.1 days versus 2.05 +/- 0.9 days) with p-value 0.0001. Stone free rate in mini-PCNL group was 80% versus 85% in standard-PCNL however; this difference was not statistically significant (Table 
Preoperative, intraoperative, and postoperative parameters
Hb (gm/dl)Collecting system perforation(DJ fixation)
Hb drop (gm/dl)Change in Creatinine(mg/dl)0.580.00.640.111.640.070.930.240.00010.272




Operative and postoperative outcome in mini-PCNL vs standard-PCNL: (