RT - Article
SR - Electronic
T1 - Comparing laser vs mechanical lithotripsy in suction mini-PCNL for kidney stone disease: A prospective multicentre study by the endourology section of EAU
JF - BJUI COMPASS
SP - 2026-05-24
DO - 10.1002/bco2.70075
A1 - Angelo Cormio, 
A1 - Vineet Gauhar, 
A1 - Bhaskar K. Somani, 
A1 - Jaisukh Kalathia, 
A1 - Nariman Gadzhiev, 
A1 - Marek Zawadzki, 
A1 - Mahmoud Laymon, 
A1 - Karl Tan, 
A1 - Gopal Ramdas Tak, 
A1 - Theodoros Tokas, 
A1 - Madhu Sudan Agrawal, 
A1 - Jean de la Rosette, 
A1 - Kremena Petkova, 
A1 - Kazumi Taguchi, 
A1 - Dmitriy Gorelov, 
A1 - Alexey G. Martov, 
A1 - Leonardo Gomes Lopes, 
A1 - Mehmet ilker Gökce, 
A1 - Wissam Kamal, 
A1 - Stefania Ferretti, 
A1 - Devang Desai, 
A1 - Yadgar Abduljabbar Shwani, 
A1 - Khi Yung Fong, 
A1 - Steffi Kar Kei Yuen, 
A1 - Andreas Skolarikos, 
A1 - Marcos Cepeda, 
A1 - Thomas R. W. Herrmann, 
A1 - Daniele Castellani, 
YR - 2025
UL - https://repo.bashgmu.ru/publication/5407
AB - Objectives: To compare perioperative outcomes, complications and stone-free rates
(SFRs) between laser and non-laser lithotripsy in suction-assisted mini-PCNL
(SM-PCNL).
Subjects and Methods: This prospective multicentre study enrolled adults with normal kidneys undergoing SM-PCNL (14–22 Fr) across 30 international centres
(March–November 2024). Patients were divided into laser (Group 1) and non-laser
(Group 2) groups. Propensity score matching (2:1) was performed based on age, sex,
Guy’s score and patient position. Primary outcomes were complications and 30-day
SFR assessed by CT. Multivariable logistic regression identified predictors of complete stone clearance and complications.
Results: After matching, 748 patients were analysed (Group 1: 448; Group 2: 300).
Non-laser devices were associated with shorter lithotripsy (12 vs 18 min, p < 0.001)
and operative times (37 vs 45 min, p < 0.001) and higher SFR (intraoperative: 91.3%
vs 80.7%; 30-day: 87.7% vs 82.1%). However, transfusions (3.3% vs 0.2%), pelvic
perforation and pleural injury (each 3.0%) were more common in Group 2. On multivariable analysis, single-step dilation (OR 3.05) and sheath sizes of 16.5–18 Fr
(OR 1.98) or 20–22 Fr (OR 2.72) were associated with higher odds of stone-free status, while skin-to-stone distance >8 cm (OR 0.5) and combined fluoroscopy/ultrasound access (0.28) reduced this likelihood. Stone volume (OR 1.03), serial dilation with non-metal dilators (OR 2.64) and combined fluoroscopy/ultrasound access
(OR 2.11) were factors associated with higher odds of complications. The lithotripsy
technology had no direct bearing on complications.
Conclusions: Both laser and non-laser lithotripsy are effective in SM-PCNL. Nonlaser devices improve efficiency and lasers were preferentially used with 14–18 fr
access tracts.