Vacuum-assisted access sheath in supine mini-percutaneous nephrolithotomy (mini-PCNL)

Introduction: The vacuum-assisted access sheath is a new device for the treatment of kidney stones with percutaneous nephrolithotomy (PCNL).Objective: Our aim was to compare the stone-free rate (SFR) and complications between stan-dard mini percutaneous nephrolithotomy (mini-PCNL) and vacuum-assisted PCNL (Va-PCNL).Methods: Retrospective study of patients undergoing mini-PCNL and Va-PCNL from January 2018 to June 2022. Va-PCNL was performed with a disposable sheath (ClearPetra) with con-tinuous high-flow irrigation and vacuum fluid dynamics for easier stone fragment removal. Baseline patient characteristics, surgical outcomes, perioperative and postoperative data were collected. We compared SFR and complications.Results: A total of 136 patients were identified, 57 (41,9%) underwent Va-PCNL and 79 (58,15%) mini-PCNL. Mean operative time was significantly shorter in the Va-PCNL group (95 min.) than in mini-PCNL (146 min.; P = .001) group. The tubeless technique was performed more frequently in Va-PCNL group (61,4% vs. 34,2%; P = .002). We did not observe any differences in postoperative complications. The mean hospital stay was significantly lower in Va-PCNL with 1,7 + 1,9 days per patient compared with 2,7 + 1,5 days in the mini-PCNL group (P = .001). There were no differences in SFR at 3 months between Va-PCNL (71,9%) and mini-PCNL (71,8%; P = .848). Conclusion: Patients treated with Va-PCNL had comparable results to mini-PCNL, showing equal SFR with similar infectious complications rates. Potential benefits of Va-PCNL include shorter operative time and postoperative stay.(c) 2023 AEU. Published by Elsevier Espan similar to a, S.L.U. All rights reserved.