Micropercutaneous Versus Minipercutaneous for the Management of Moderately Sized Kidney Stones: A Systematic Review and Meta-Analysis

Abstract Background: To assess the efficacy and safety of mini-percutaneous nephrolithotomy (Miniperc) and micropercutaneous nephrolithotomy (Microperc) for moderately sized renal stones. Methods: Literature search of PubMed, Web of Science, and Embase was performed before January 2020. We used odds ratios (OR) and weighted mean difference (WMD) for dichotomous variables and continuous variables, respectively. Results were pooled by Review Manager version 5.3 software. Results: A total of 4 studies involving 172 Microperc and 162 Miniperc cases were included. The overall SFR of Microperc was 86.05% (148/172), while the SFR of the Miniperc was 87.65% (142/162). Microperc was associated with lower hemoglobin drop (WMD: -0.98; P = 0.03), higher renal colic requiring D-J stent insertion (OR: 3.49; P=0.01). No significant differences exist between Microperc and Miniperc with respect to stone-free rate (SFR) (OR: 0.90; P=0.75), urinary tract infection (OR: 0.38; P=0.18), operative time (WMD: 14.73; P = 0.54) and hospital stay time (WMD: -1.04; P=0.07). Conclusions: Our meta-analysis demonstrated that Microperc could obtain comparable SFR with Miniperc. Microperc was associated with lower hemoglobin drop, but Miniperc was associated with lower renal colic rates. In addition, the operation time and hospital stay time for these two procedures were similar.