KẾT QUẢ TÁN SỎI THẬN QUA DA ĐƯỜNG HẦM NHỎ KHÔNG DẪN LƯU THẬN TẠI BỆNH VIỆN HÀ GIANG NĂM 2025

Abstract

Objective: To evaluate the outcomes of tubeless mini-percutaneous nephrolithotomy (mini-PCNL) for renal stones at Ha Giang Hospital in 2025. Materials and Methods: A prospective descriptive study was conducted on 52 patients diagnosed with renal calculi who underwent tubeless mini-PCNL from January to June 2025. Results: A total of 82.7% of patients presented with flank pain, 15.4% experienced renal colic, and 1.9% had gross hematuria. The mean stone size on computed tomography was 28.23 ± 8.58 mm (range: 17–52 mm), with 57.7% measuring 20–30 mm. Single stones were present in 30.8% of patients, whereas 69.2% had multiple stones; 69.2% were complex stones involving both the renal pelvis and calyces. Hydronephrosis was predominantly grade I (51.9%) and grade II (26.9%), with only 3.8% of patients exhibiting grade III. Complete stone clearance was achieved in 86.5% of cases, while 13.5% had residual fragments >3 mm managed conservatively. The mean operative time was 58.17 ± 15.56 minutes (30–100 min), mean postoperative hospital stay was 3.02 ± 1.73 days (1–12 days), and mean duration of analgesic use was 2.10 ± 0.7 days with intravenous Paracetamol. The overall complication rate was 11.5%, including postoperative fever in 1.9% and secondary bleeding in 9.6% (4 cases managed conservatively and 1 requiring selective embolization). Conclusion: Tubeless mini-PCNL is an effective and safe treatment modality for complex renal stones, offering high stone-free rates, shorter hospitalization, and reduced postoperative analgesic requirements.