Comparison of minimally invasive suction-evacuation versus standard nephrostomy sheaths for the treatment of partial staghorn stones

We conducted a prospective, randomized study to compare the safety and efficacy of using a conventional nephrostomy sheath (CNS) versus a minimally invasive suction-evacuation nephrostomy sheath (SENS) for treating partial staghorn stones. Eighty-six patients with partial staghorn stones were randomly assigned into two groups, with 43 patients in each group. One group underwent standard percutaneous nephrolithotomy (sPCNL) using CNS, whereas the other group underwent minimally invasive percutaneous nephrolithotomy (mPCNL) with SENS. Patient demographics, stone characteristics, intraoperative data, perioperative data, and surgical results were collected and analyzed.The patient demographics and stone characteristics were similar in both groups. The SENS group had significantly lower peak and mean intrarenal pressure (IRP) during the procedure. The stone-free rate (SFR) was comparable between groups. The SENS group removed stones more efficiently, with shorter treatment time and less frequent use of the stone extractor. Lower IRP and shorter treatment time led to fewer postoperative complications.mPCNL with SENS results in lower IRP, faster stone removal, and reduced use of stone forceps while preserving SFR and safety.