Multitract mini-percutaneous nephrolithotomy (mini-PCNL) has emerged as an effective treatment for complex renal stones, offering reduced morbidity compared to standard PCNL. The totally tubeless approach, omitting nephrostomy tubes and ureteral stents, aims to enhance recovery and minimize postoperative discomfort. This study reports the clinical characteristics and outcomes of the first 10 cases of this procedure performed in Vietnam, marking a pioneering step in minimally invasive stone management.

A retrospective study was conducted on 10 patients with complex renal calculi (staghorn or multiple stones >2 cm) treated with multitract mini-PCNL (tract size ≤18 Fr) without nephrostomy tubes or ureteral stents from 2022 to 2024. Clinical characteristics, including demographics, stone burden were recorded. Outcomes assessed included stone-free rate (SFR), hospital stay, hemoglobin drop and complications (Clavien-Dindo classification).

The cohort comprised 9 males and 1 female, mean age 54.1 ± 4.9 years. Only one patient had staghorn calculi and 7 had multiple stones with 2 – 4 tracts per case. The SFR was 80% at 4 weeks. Median hospital stay was 2 days, and mean hemoglobin drop was 1.02 ± 0.63g/dL. No blood transfusions were needed. Complications occurred in 3 patients (30%): 2 Clavien I (fever) and 1 Clavien II (urinary tract infection).

Totally tubeless multi-tract mini-percutaneous nephrolithotomy (PCNL) in Vietnam has demonstrated safety and efficacy for complex renal stones, especially multi-calyx stones. This approach is associated with a high stone-free rate (SFR), short hospital stays, no increased bleeding or transfusion rates, a reduced need for postoperative analgesics, cost savings through early discharge, quicker return to work, and flexible ureteronephroscope costs. Larger studies are needed to confirm these findings and optimize patient selection.