Design: Systematic review and meta-analysis (2 RCTs, 3 cohorts)
Population: 490 children undergoing PCNL
Primary outcome: Stone-free rate
Effect: RR 0.98 (0.93 to 1.04); grade I complications RR 0.46 with mini-PCNL

This meta-analysis, published 18 September, pooled five studies — two randomised trials and three retrospective cohorts — with 490 children undergoing mini or standard percutaneous nephrolithotomy.

Stone-free rates were the same (RR 0.98, 95% CI 0.93 to 1.04; I² 0%). Mini-PCNL took about 7.5 minutes longer (95% CI 0.2 to 14.9) but had fewer Clavien-Dindo grade I complications (RR 0.46). Postoperative fever and grade II–IV complications did not differ.

For paediatric stone disease, which is common in parts of India, mini-PCNL offers the same clearance with a smaller tract and fewer minor complications, at the cost of a few extra minutes in theatre.

Mini-PCNL and standard PCNL gave the same stone-free rates in children.
Mini-PCNL was associated with fewer minor complications.
Expect slightly longer operating time with mini-PCNL.
Major complications and fever did not differ between techniques.

Why it matters

Supports a less invasive approach in children without trading away stone clearance.

The statistics, in plain English

A relative risk of 0.98 with a tight confidence interval means stone clearance was essentially identical. The operating-time estimate is less certain, with high heterogeneity (I² 78%).