Efficacy and safety of super-mini percutaneous nephrolithotomy in the treatment of urinary calculi: a systematic review and meta-analysis

BACKGROUND: Super-mini-percutaneous nephrolithotomy (SMP) is feasible and safe in adults and children with moderate-size renal calculi, but the use of SMP to remove larger calculi has yet to be determined. This study aimed to review the efficacy (stone-free rate, SFR) and safety of SMP in treating urinary calculi. METHODS: PubMed, the Cochrane Library, and Embase were searched for eligible studies published up to May 2021. The primary outcome was the SFR. The secondary outcomes were the complications (using the Clavien-Dindo grading system), pain score, hospitalization days, and mean hemoglobin decline. All analyses were performed using the random-effects model. Nine studies (2433 patients with SMP and 2178 controls) were included. RESULTS: SMP was not associated with an improved SFR in patients with calculi (RR = 1.05, 95%CI: 0.99–1.11). There were no differences in the occurrence of Clavien-Dindo I (RR = 0.95, 95%CI: 0.67–1.35) and Clavien-Dindo II (RR = 0.91, 95%CI: 0.58–1.42) complications between SMP and the control procedures. There were more Clavien-Dindo III complications with SMP than with the control procedures (RR = 0.71, 95%CI: 0.55–0.91), but none of the individual complications significantly differed between the two groups. Clavien-Dindo I fever appeared to be higher with SMP than with the control procedure (RR = 0.64, 95%CI: 0.50–0.83). CONCLUSION: In terms of efficacy, there were no differences between SMP and other procedures in treating urinary calculi. Clavien-Dindo I fever and Clavien-Dindo III complications might be more frequent with SMP than other procedures. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12894-023-01256-z.