{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T07:40:08Z","timestamp":1792309208528,"version":"4.4.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate how standard operating procedures (SOPs), modification in puncture techniques, advancements in preoperative imaging to better understand calyceal anatomy have revitalized standard percutaneous nephrolithotomy (PCNL) for large kidney stones (&gt;2.5\u2009cm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>At our center, renal stones are managed with extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS) according to stone characteristics and patient profile. Renal stones larger than 2.5\u2009cm are managed with standard PCNL. In this retrospective study patients undergoing standard PCNL at a tertiary healthcare center from January 2018 to December 2023 having complete records were included. Data on demographics, stone characteristics, operative details, and outcomes were assessed using SPSS v26, with ethical approval ensuring confidentiality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 766 patients were included. Mean age was 43.75\u2009\u00b1\u200916.0\u2009years; 69.7% were male. Mean stone size was 3.8\u2009\u00b1\u20091.2\u2009cm, with 46.7% complex (Guy\u2019s Stone Score [GSS]\u2009\u2a7e\u20092). Using a 24\u2009\u00b1\u20093\u2009Fr sheath and 1.3 tracts per procedure, operative time averaged 92.5\u2009\u00b1\u200920.3\u2009min. Stone clearance was 91.3%, with significant intraoperative bleeding (requiring transfusion) in 1.7%. Overall complication rate was 16.4%, and hospital stay averaged 3.6\u2009\u00b1\u20091.2\u2009days; 8.7% required additional interventions, including RIRS in 44.3% of those cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Modern standard PCNL achieves high clearance (91.3%) with minimal morbidity, reaffirming its role for large stones despite mini-PCNL\u2019s rise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03915603261457526","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:40:28Z","timestamp":1783417228000},"page":"551-559","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The current standing of standard PCNL in the era of miniaturization"],"prefix":"10.1177","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-4275","authenticated-orcid":false,"given":"Deepak Prakash","family":"Bhirud","sequence":"first","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0222-5791","authenticated-orcid":false,"given":"Jaideep Singh","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4859-3979","authenticated-orcid":false,"given":"Shiv Charan","family":"Navriya","sequence":"additional","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5044-3040","authenticated-orcid":false,"given":"Vikram","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam Ram","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8769-8269","authenticated-orcid":false,"given":"Mahendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun Singh","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Urology, AIIMS Jodhpur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2011.0235"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.07259.x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)32283-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/2035851"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000959"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.11.028"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2005.02.010"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2010.0111"},{"key":"e_1_3_3_10_2","first-page":"150","article-title":"Safety and efficacy of total tubeless mini-percutaneous nephrolithotomy","volume":"24","author":"Khan M","year":"2024","unstructured":"Khan M, et al. Safety and efficacy of total tubeless mini-percutaneous nephrolithotomy. BMC Urol 2024; 24: 150.","journal-title":"BMC Urol"},{"key":"e_1_3_3_11_2","first-page":"2","article-title":"Contemporary management of large renal calculi","volume":"34","author":"Desai J","year":"2023","unstructured":"Desai J, et al. Contemporary management of large renal calculi. J Urol Surg 2023; 34: 2.","journal-title":"J Urol Surg"},{"key":"e_1_3_3_12_2","first-page":"177","article-title":"Comparative outcomes of robot-assisted laparoscopic pyelolithotomy and mini-percutaneous nephrolithotomy","volume":"18","author":"Desai M","year":"2025","unstructured":"Desai M, et al. Comparative outcomes of robot-assisted laparoscopic pyelolithotomy and mini-percutaneous nephrolithotomy. Int J Nephrol Renovasc Dis 2025; 18: 177\u2013185.","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"e_1_3_3_13_2","doi-asserted-by":"crossref","unstructured":"Mantica G Balzarini F Chierigo F et al. The fight between PCNL laparoscopic and robotic pyelolithotomy: do we have a winner? A systematic review and meta-analysis. 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J Coll Physicians Surg Pak 2011; 21(3): 138\u2013141.","journal-title":"J Coll Physicians Surg Pak"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-017-0266-7"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.afju.2018.10.002"},{"key":"e_1_3_3_23_2","doi-asserted-by":"crossref","unstructured":"Tufano A Frisenda M Rossi A et al. External validation of Resorlu-unsal stone score in predicting outcomes after retrograde intrarenal surgery. Experience from a single institution. Arch Ital Urol Androl 2022; 94(3): 311\u2013314. https:\/\/doi.org\/10.4081\/aiua.2022.3.311","DOI":"10.4081\/aiua.2022.3.311"},{"key":"e_1_3_3_24_2","doi-asserted-by":"crossref","unstructured":"Sighinolfi MC Calcagnile T Ticonosco M et al. External validation of a nomogram for outcome prediction in management of medium-sized (1-2 cm) kidney stones. 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