Introduction: PCNL has become a standard minimally invasive treatment for renal stones. Tubeless PCNL is associated with less morbidity. Miniaturisation of instruments leads decrease morbidity of procedure. We compared standard tubeless PCNL to Miniperc tubeless PCNL for morbidity and stone free rates in order to improve outcomes of PCNL with minimal morbidity . Methods: Our study included 100 patients , 50 patients in group 1 (standard tubeless PCNL) & 50 patients in group 2 (tubeless mini PCNL) , with single renal stone less than 2 cm . Patients with CKD, solitary kidney , ectopic kidney and previous diversion were excluded. Tract was dilated upto 24Fr in group 1 & upto 16Fr in group 2 . No percutaneous nephrostomy was kept. Post operative pain score was monitored at 12 and 24 hours. Additional analgesia was given if needed . Hemoglobin was measured pre operatively & on post op day 1. Stone clearance was checked with ultrasonography & XRay KUB (kidney-ureter-bladder ) . Total Operative time , pain score, analgesic requirement, haemoglobin drop, complications (bleeding,fever,urinary leak,urosepsis,hydro or pneumothorax) and stone free rate were compared. Results: Miniperc operative time was longer than standard PCNL(45±10 vs 35±8mins. P<0.001). Median pain score at 12 and 24 hours was more in group 1 than in group 2 (6±1 VS 4±1, P<0.0001 and 3±1 vs 2±1, P<0.001). post operative hemoglobin drop was more in group 1 than in group 2 ( 0.95±0.2 VS 0.6±0.1 , P<0.0001). Stone clearance in group 1 was 100% while in group 2 it was 95%. There was no significant difference in complications between the two groups . Conclusions: Both Standard tubeless PCNL & tubeless Mini PCNL are effective for renal stones less than 2cm. Operative time is more in tubeless Mini PCNL whereas pain score, analgesics requirement and hemoglobin drop are more in standard tubeless PCNL comparatively . Stone clearance in both groups is comparable and more than 95%. SOURCE OF Funding: nil
