Comparing micropercutaneous nephrolithotomy and retrograde intrarenal surgery in treating 1–2 cm solitary renal stones in pediatric patients younger than 3 years

Abstract

To compare the effects of micropercutaneous nephrolithotomy (micro-PCNL) and retrograde intrarenal surgery (RIRS) in treating 1-2cm solitary renal stones in pediatric patients aged less than 3 years. A retrospective analysis was performed on data from 57 children younger than 3 yearswho received micro-PCNL and RIRS surgery in the authors hospital from October 2016 to August 2018. The patients were divided into group 1, the micro-PCNL group, and group 2, the RIRS group. Peri-operative data including surgical time, number of anesthesia sessions, stone-free rate (SFR), and complications were analyzed. There were 27 patients in group 1 and 30 patients in group 2, and the patients' mean ages were 19±9.9 months and 21±7.8 months, respectively (P=0.462). The stone size was 1.6±0.3cm in group 1 and 1.7±0.2cm in group 2 (P=0.217); the mean surgical time was 52±7min in group 1 and 48±9min in group 2 (P=0.163), and the mean lithotripsy time was 21±4min in group 1 and 23±5min in group 2 (P=0.148); and the SFR at 1 month after surgery was 88.9% in group 1 and 86.7% in group 2 (P=0.799). The number of anesthesia sessions for patients was 1.4±0.5 in group 1 and 2.7±0.5 in group 2 (P<0.001). The complication rate was 14.8% and 16.7% in group 1 and group 2, respectively (P=0.714). None of the patients needed conversion to the 12-14F mini-PCNL. The results of this study showed that the surgical effects and complications from micro-PCNL and RIRS in treating young children with 1-2cm solitary renal stones were similar. However, micro-PCNL reduced the need to prestent before surgery and allowed lower anesthesia sessions. Therefore, micro-PCNL is an effective alternative method for 1-2cm solitary renal stones in patients below 3 years of age.