Evidence map›Paper›PMID 42327361›Full record

ArticleResearch and reports in urology2026

Vacuum-Assisted Mini-PCNL is Associated with Lower Postoperative SIRS: A Real-World Cohort Study.

Surawach Piyawannarat, Kun Sirisopana, Nipapan Choonu, Yada Phengsalae, Premsant Sangkum, Chinnakhet Ketsuwan, Wisoot Kongchareonsombat

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Article in Research and reports in urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Surawach PiyawannaratDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.ORCID 0009-0007-1489-5991
Kun SirisopanaDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Nipapan ChoonuDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Yada PhengsalaeDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Premsant SangkumDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chinnakhet KetsuwanDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Wisoot KongchareonsombatDivision of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0002-9282-647X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Postoperative systemic inflammatory response syndrome (SIRS) remains a key complication after mini-percutaneous nephrolithotomy (mini-PCNL) and is often related to elevated intrarenal pressure and bacterial translocation. Vacuum-assisted mini-PCNL (VmPCNL) has been developed to mitigate this risk through active pressure control. Objective: To evaluate the association between VmPCNL and postoperative SIRS and to identify the independent predictors of SIRS in a real-world cohort. Materials and Methods: A retrospective cohort study was conducted of patients undergoing mini-PCNL at a tertiary referral center between January 2021 and May 2025. Patients were stratified into standard mini-PCNL (SmPCNL) and VmPCNL groups. The primary endpoint was SIRS within 48 hours post-surgery. Secondary outcomes included operative time, stone-free rate (SFR), and length of hospital stay (LOS). Multivariable logistic regression was used to identify independent predictors of SIRS. Results: A total of 136 patients were included in the study (SmPCNL, n = 78; VmPCNL, n = 58). The incidence of postoperative SIRS was significantly lower in the VmPCNL group (8.6% vs 21.8%, p = 0.036). VmPCNL was also associated with shorter operative time (median 90 minutes vs 115 minutes, p = 0.038) and reduced LOS (p = 0.012). Stone-free rates were comparable between the groups, indicating no compromise in procedural efficacy. In the multivariable analysis, VmPCNL was independently associated with a lower risk of SIRS (adjusted OR [aOR] 0.44, 95% CI 0.19-0.98, p = 0.041), while a positive preoperative urine culture was an independent risk factor (aOR 2.60, 95% CI 1.01-6.60, p = 0.045). Conclusion: In this real-world cohort, VmPCNL was associated with a lower SIRS incidence and improved perioperative efficiency without compromising stone-free outcomes. The mechanism may involve improved intraoperative outflow dynamics through active suction, although direct measurement of intrarenal pressure is needed to confirm this hypothesis.

Indexed as

intrarenal pressurekidney stonesmini-PCNLsystemic inflammatory response syndromevacuum-assisted

Identifiers

PMID42327361
PMCPMC13281880

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.