COMPARATIVE ANALYSIS OF MINIPERCUTANEOUS NEPHROLITHOTRIPSY AND EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY IN THE TREATMENT OF NEPHROLITHIASIS: A MODERN PERSPECTIVE BASED ON A LITERATURE REVIEW

Abstract

This narrative review synthesizes contemporary literature on miniaturized percutaneous nephrolithotripsy (mini-PCNLT), examining its evolution, comparative efficacy, safety profile, technical advancements, and emerging clinical applications. Through analysis of recent systematic reviews, meta-analyses, randomized controlled trials, and observational studies, we evaluate mini-PCNLT's position within the modern endourological arsenal relative to extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopy (fURS), and standard percutaneous nephrolithotripsy. The evidence demonstrates that mini-PCNLT has matured from an experimental technique into an established treatment modality that bridges the gap between less invasive but often less effective ESWL and more invasive traditional percutaneous approaches. For intermediate-sized stones (1-2 cm), particularly in challenging anatomical locations, mini-PCNLT offers comparable efficacy to fURS with reduced radiation exposure. For larger stone burdens (>2 cm), it provides similar stone clearance to standard percutaneous nephrolithotripsy with significantly improved safety parameters. Technical innovations, including ureteral access sheath integration and refined laser technologies, continue to expand its applicability. This review contextualizes mini-PCNLT within current treatment algorithms and identifies future directions for research and clinical implementation.