TY  - JOUR
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
DO  - 10.1002/bco2.70075
AU  - Angelo Cormio, 
AU  - Vineet Gauhar, 
AU  - Bhaskar K. Somani, 
AU  - Jaisukh Kalathia, 
AU  - Nariman Gadzhiev, 
AU  - Marek Zawadzki, 
AU  - Mahmoud Laymon, 
AU  - Karl Tan, 
AU  - Gopal Ramdas Tak, 
AU  - Theodoros Tokas, 
AU  - Madhu Sudan Agrawal, 
AU  - Jean de la Rosette, 
AU  - Kremena Petkova, 
AU  - Kazumi Taguchi, 
AU  - Dmitriy Gorelov, 
AU  - Alexey G. Martov, 
AU  - Leonardo Gomes Lopes, 
AU  - Mehmet ilker Gökce, 
AU  - Wissam Kamal, 
AU  - Stefania Ferretti, 
AU  - Devang Desai, 
AU  - Yadgar Abduljabbar Shwani, 
AU  - Khi Yung Fong, 
AU  - Steffi Kar Kei Yuen, 
AU  - Andreas Skolarikos, 
AU  - Marcos Cepeda, 
AU  - Thomas R. W. Herrmann, 
AU  - Daniele Castellani, 
Y1  - 2026-05-24
UR  - https://repo.bashgmu.ru/publication/5407
N2  - 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.