NCT07697677

Brief Summary

Kidney stones that are large or complex are often treated with percutaneous nephrolithotomy, also called PCNL. Standard PCNL uses a larger access tract and is effective for removing complex kidney stones, but it may be associated with more bleeding, pain, and recovery burden. Modified mini-PCNL uses a smaller access tract and may reduce surgical trauma while maintaining a similar stone clearance rate. This multicenter randomized trial will compare modified mini-PCNL using a 20 Fr access sheath with standard PCNL using a 24 Fr access sheath in adults with complex renal stones. About 1,380 participants from 8 urology centers will be randomly assigned to receive one of the two procedures. The main purpose of the study is to determine whether modified mini-PCNL is not worse than standard PCNL in achieving stone-free status shortly after surgery. Stone-free status will be assessed by low-dose noncontrast CT within 72 hours after surgery. The study will also compare stone-free status at 3 months, complications, operation time, length of hospital stay, need for additional procedures, and quality of life.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,380

participants targeted

Target at P75+ for not_applicable

Timeline
13mo left

Started Jul 2026

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress4%
Jul 2026Sep 2027

First Submitted

Initial submission to the registry

July 7, 2026

Completed
6 days until next milestone

First Posted

Study publicly available on registry

July 13, 2026

Completed
2 days until next milestone

Study Start

First participant enrolled

July 15, 2026

Completed
12 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 14, 2027

Expected
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 14, 2027

Last Updated

July 13, 2026

Status Verified

July 1, 2026

Enrollment Period

12 months

First QC Date

July 7, 2026

Last Update Submit

July 7, 2026

Conditions

Keywords

Percutaneous NephrolithotomyMini-PCNLStandard PCNLModified Mini-PCNLComplex Renal StonesStone-Free RateRandomized Controlled Trial

Outcome Measures

Primary Outcomes (1)

  • Immediate Stone-Free Rate

    Proportion of participants who achieve stone-free status after surgery. Stone-free status is defined as no residual stone visualized under endoscopy and no residual stone fragments, or residual fragments ≤2 mm, on low-dose noncontrast CT with 2-mm slice thickness.

    Within 72 hours after surgery

Secondary Outcomes (2)

  • Stone-Free Rate at 3 Months

    3 months after surgery

  • Length of Hospital Stay

    From surgery to hospital discharge, assessed up to 30 days after surgery

Study Arms (2)

Modified Mini-PCNL

EXPERIMENTAL

Participants randomized to this arm will undergo 20 Fr modified mini percutaneous nephrolithotomy using the F17 Hawk nephroscope for the treatment of complex renal stones.

Procedure: 20 Fr Modified Mini Percutaneous Nephrolithotomy

Standard PCNL

ACTIVE COMPARATOR

Participants randomized to this arm will undergo 24 Fr standard percutaneous nephrolithotomy using the F20.8 Wolf nephroscope for the treatment of complex renal stones.

Procedure: 24 Fr Standard Percutaneous Nephrolithotomy

Interventions

Standard percutaneous nephrolithotomy performed with a 24 Fr access sheath and F20.8 Wolf nephroscope. Stone fragmentation may be performed using pneumatic lithotripsy, Ho:YAG laser, or thulium fiber laser according to the standardized surgical protocol.

Also known as: Standard PCNL, sPNL, 24 Fr Standard PCNL
Standard PCNL

Modified mini percutaneous nephrolithotomy performed with a 20 Fr access sheath and F17 Hawk nephroscope. Stone fragmentation may be performed using pneumatic lithotripsy, Ho:YAG laser, or thulium fiber laser according to the standardized surgical protocol.

Also known as: Modified Mini-PCNL, Modified mPNL, 20 Fr Modified Mini-PCNL
Modified Mini-PCNL

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adults aged ≥18 years.
  • Serum creatinine ≤133 μmol/L.
  • American Society of Anesthesiologists (ASA) physical status classification I-III.
  • S.T.O.N.E. score ≥8.
  • Complex renal stones confirmed by noncontrast computed tomography, including stone surface area \>1500 mm², multiple calyceal stones, partial or complete staghorn calculi, or complex anatomical conditions.
  • Patients who provide written informed consent and agree to undergo either modified mini-percutaneous nephrolithotomy or standard percutaneous nephrolithotomy.

You may not qualify if:

  • Solitary kidney.
  • Morbid obesity (body mass index ≥35 kg/m²).
  • Previous renal transplantation or urinary diversion.
  • Congenital abnormalities of the urinary tract.
  • Pregnancy.
  • Uncorrected coagulopathy.
  • Active urinary tract infection.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The First Affiliated Hospital of Guangzhou Medical University

Guangzhou, Guangdong, 510120, China

RECRUITING

Related Publications (1)

  • Zeng G, Cai C, Duan X, Xu X, Mao H, Li X, Nie Y, Xie J, Li J, Lu J, Zou X, Mo J, Li C, Li J, Wang W, Yu Y, Fei X, Gu X, Chen J, Kong X, Pang J, Zhu W, Zhao Z, Wu W, Sun H, Liu Y, la Rosette J. Mini Percutaneous Nephrolithotomy Is a Noninferior Modality to Standard Percutaneous Nephrolithotomy for the Management of 20-40mm Renal Calculi: A Multicenter Randomized Controlled Trial. Eur Urol. 2021 Jan;79(1):114-121. doi: 10.1016/j.eururo.2020.09.026. Epub 2020 Sep 29.

MeSH Terms

Conditions

Kidney Calculi

Condition Hierarchy (Ancestors)

NephrolithiasisKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesUrolithiasisUrinary CalculiMale Urogenital DiseasesCalculiPathological Conditions, AnatomicalPathological Conditions, Signs and Symptoms

Central Study Contacts

Yongda Liu, Doctor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor and Director, Department of Urology

Study Record Dates

First Submitted

July 7, 2026

First Posted

July 13, 2026

Study Start

July 15, 2026

Primary Completion (Estimated)

July 14, 2027

Study Completion (Estimated)

September 14, 2027

Last Updated

July 13, 2026

Record last verified: 2026-07

Locations