Propensity Score–matched Analysis of 30-day Outcomes of Suction Versus Nonsuction Mini Percutaneous Nephrolithotomy from a Real-World Multicenter Prospective Study: Collaboration Between the European Association of Urology Endourology Section and the Asian Urological Society of Endoluminal Surgery and Technology

Issued Date

2025-01-01

Resource Type

Article

eISSN

24054569

DOI

10.1016/j.euf.2025.12.011

Scopus ID

2-s2.0-105025582070

Pubmed ID

41421929

Journal Title

European Urology Focus

Rights Holder(s)

SCOPUS

Bibliographic Citation

European Urology Focus (2025)

Suggested Citation

Yuen S.K.K., Pek G.X.W., Herrmann T., Castellani D., Fong K.Y., Kalathia J., Zhu W., Tak G.R., Cepeda M., Gadzhiev N., Malkhasyan V., Al Hadithi M., Kukreja R., Chawla A., Agrawal M.S., Vaddi C.M., Inoue T., Dhandapani V., Akdogan N., Tefik T., Kumar N., Petkova K., Baker A., Tan K.M., Ketsuwan C., Laymon M., Sarica K., Omar M., Martov A., Zeng G., Somani B.K., Gauhar V. Propensity Score–matched Analysis of 30-day Outcomes of Suction Versus Nonsuction Mini Percutaneous Nephrolithotomy from a Real-World Multicenter Prospective Study: Collaboration Between the European Association of Urology Endourology Section and the Asian Urological Society of Endoluminal Surgery and Technology. European Urology Focus (2025). doi:10.1016/j.euf.2025.12.011 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113744

Title

Propensity Score–matched Analysis of 30-day Outcomes of Suction Versus Nonsuction Mini Percutaneous Nephrolithotomy from a Real-World Multicenter Prospective Study: Collaboration Between the European Association of Urology Endourology Section and the Asian Urological Society of Endoluminal Surgery and Technology

Author(s)

Yuen S.K.K.
 Pek G.X.W.
 Herrmann T.
 Castellani D.
 Fong K.Y.
 Kalathia J.
 Zhu W.
 Tak G.R.
 Cepeda M.
 Gadzhiev N.
 Malkhasyan V.
 Al Hadithi M.
 Kukreja R.
 Chawla A.
 Agrawal M.S.
 Vaddi C.M.
 Inoue T.
 Dhandapani V.
 Akdogan N.
 Tefik T.
 Kumar N.
 Petkova K.
 Baker A.
 Tan K.M.
 Ketsuwan C.
 Laymon M.
 Sarica K.
 Omar M.
 Martov A.
 Zeng G.
 Somani B.K.
 Gauhar V.

Author's Affiliation

Chinese University of Hong Kong
 Hannover Medical School
 Stellenbosch University
 İstanbul Tıp Fakültesi
 Singapore General Hospital
 University Hospital Southampton NHS Foundation Trust
 Kasturba Medical College, Manipal
 Faculty of Medicine
 The First Affiliated Hospital of Guangzhou Medical University
 Ramathibodi Hospital
 A.I. Yevdokimov Moscow State University of Medicine and Dentistry
 Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
 Menoufia University Faculty of Medicine
 Hospital Universitario Río Hortega
 Biruni Üniversitesi
 Çukurova Üniversitesi Tip Fakültesi
 A.I. Burnasyan Federal Medical Biophysical Center FMBA
 Military Medical Academy, Sofia
 Kantonsspital Frauenfeld
 Saint-Petersburg State University Hospital
 Ng Teng Fong General Hospital
 Hara Genitourinary Hospital
 Asian Institute of Nephrology and Urology
 Hazm Mebaireek General Hospital
 Ford Hospital and Research Centre
 Fortune Urology Clinic
 Veterans Memorial Medical Center
 Pushpanjali Hospital & Research Centre
 Asian Institute of Nephrology and Urology
 Urocare Hospital
 Ramadi Teaching Hospital
 Remedy Hospital LN

Corresponding Author(s)

Yuen S.K.K.

Other Contributor(s)

Mahidol University

Abstract

Background and objective: This study compares 30-d perioperative outcomes between suction mini percutaneous nephrolithotomy (S-mPCNL) and nonsuction mPCNL (NS-mPCNL). Methods: This prospective multicenter study involved 20 surgeons from 14 countries. The primary outcome was the 30-d stone free rate (SFR) on computed tomography. Propensity score matching (PSM) was used to adjust for baseline differences between the two groups. Multivariable logistic regression was used to evaluate factors associated with 100% SFR and the overall complication rate. Key findings and limitations: PSM for 1915 patients (1534 S-mPCNL, 381 NS-mPCNL) yielded a cohort of 664 S-mPCNL and 309 NS-mPCNL cases for analysis. Baseline and stone characteristics were well matched. The 30-d 100% SFR (grade A) was high in both groups and did not significantly differ (85% vs 87%; odds ratio [OR] 0.97, 95% confidence interval [CI] 0.63–1.49; p = 0.9). The S-mPCNL group had a shorter median operative time (43 vs 57 min), higher intraoperative SFR according to visual inspection or fluoroscopy (82% vs 70%), and lower blood transfusion rate (1.3% vs 3.6%). There was no between-group difference in infectious complications. Multivariable analysis revealed that stone volume (OR 0.93, 95% CI 0.87–0.99; p = 0.021) and single-step dilatation (OR 3.28, 95% CI 1.85–5.81; p < 0.001) were significantly associated with grade A SFR. Limitations include variability in practice. Conclusions and clinical implications: Suction during mPCNL improves intraoperative stone clearance rates and reduces the operative time, with no significant difference in 30-d SFR or infectious complications. Both S-mPCNL and NS-mPCNL achieve high rates of zero residual fragments.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/113744

Collections

Scopus 2025