الفهرس 
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Abstract
” Back ground : High quality evidence is deficient to compare between mini percutaneous nephrolithotomy (MPNL) versus standard percutaneous nephrolithotomy (SPNL) in the management of renal stones. Aim of the work : We aim to assess the efficacy and safety of MPNL versus SPNL for the treatment of 10-30mm renal calculi. Patients & Methods: A registered randomized clinical trial (ID: NCT04153461) was conducted for patients >18 yrs. old with normal total kidney function and had 10-30mm renal calculi. Patients were randomized to MPNL (15 F) with laser dusting and SPNL (30 F) with pneumatic and/or ultrasonic stone disintegration. The primary outcome was the immediate stone free rate (SFR) assessed by NCCT. Stone free was defined as no stone or stone < 4mm in its maximum diameter. The secondary outcomes included post-operative complications as defined by the Clavien-Dindo grading system, post-operative pain using visual analog scale (VAS) score, patient satisfaction using Freiburg index of patient satisfaction (FIPS) and hemoglobin drop. Results and conclusion : The baseline demographic data of the patients and stone characteristics were comparable in both groups. Immediate SFR was 90.2% in MPNL and 96.2% in SPNL (p=0.08). Post-operative complications did not show significant difference between groups (p=0.2). Hemoglobin deficit was 0.7(±0.7) and 1.1(±0.8) in MPNL and SPNL, respectively (p<0.001). Postoperative pain was 3.4 ± 1.2 and 4.9 ± 1.6 in MPNL and SPNL, respectively (p<0.001). Patient satisfaction FIPS score was better in MPNL 9.6 ± 3 than SPNL 13.4 ± 4.3 (p<0.001). However, SPNL had shorter operative time 60 (20-120) compared to MPNL 74 (45-145), p<0.001. Recommendations: For patients with renal stone 10-30 mm, MPNL is as effective and safe as SPNL with less bleeding and postoperative pain and high patient satisfaction but longer operative time.