# A clinical study on minimally invasive percutaneous nephrolithotomy combined with ureteral access sheath for the treatment of kidney stones

## TL;DR

This study shows that combining a ureteral access sheath with a minimally invasive kidney stone removal procedure improves safety and efficiency.

## Contribution

The study demonstrates that using a ureteral access sheath with MPCNL reduces operation time and complications for complex kidney stones.

## Key findings

- The MPCNL + UAS group had shorter operative time and lower intraoperative renal pelvic pressure.
- The MPCNL + UAS group had a lower incidence of postoperative Clavien complications.
- No significant differences were found in stone clearance rates between the groups.

## Abstract

To investigate the efficacy and safety of minimally invasive percutaneous nephrolithotomy (MPCNL) combined with ureteral access sheath in the treatment of complex kidney stones.

Seventy patients with complex kidney stones in the author's hospital from June 2022 to December 2023 were randomized. There were 35 cases of minimally invasive percutaneous nephrolithotomy combined with ureteral access sheath and 35 cases of minimally invasive percutaneous nephrolithotomy alone.

Compared to the MPCNL group, the MPCNL + UAS group demonstrated a significantly shorter operative time (55.4 ± 9.2 min vs. 61.5 ± 12.8 min, p = 0.027), significantly lower intraoperative renal pelvic pressure (9.15 ± 4.13 mmHg vs. 11.35 ± 4.21 mmHg, p = 0.031), and a significantly lower incidence of postoperative Clavien complications (p < 0.05); however, there were no significant differences between the groups in postoperative creatinine change, stone clearance rate at 1 day postoperatively, or stone clearance rate at 30 days postoperatively (p > 0.05).

Minimally invasive percutaneous nephrolithotomy combined with ureteral access sheath is safe and effective in the treatment of complex kidney stones. Ureteral access sheath can significantly shorten the operation time of minimally invasive PCNL, keep the visual field clear, reduce the pressure of renal pelvis, and reduce the incidence of complications.