Comparison of super-mini versus mini percutaneous nephrolithotomy for the treatment of upper urinary tract stones in children: a single centre experience.

Abstract

The efficacy and safety of super-mini percutaneous nephrolithotomy (SMP, 14 Fr) was compared with mini percutaneous nephrolithotomy (MPCNL, 16 Fr) for the treatment of upper urinary tract stones in children (< 14years old). Clinical data of 133 paediatric patients with upper urinary tract stones treated with SMP or MPCNL between May 2012 and May 2019 were retrospectively analysed. The patients were divided into the SMP and MPCNL groups. Age, height, weight, stone size, operation time, stone-free rate (SFR), postoperative complications, tubeless rate, and length of postoperative hospital stay (LOS) were compared. There were 66 patients (49.6%) in the SMP and 67 patients (50.4%) in the MPCNL group. No significant difference in the median age, weight, height and operation time, and SFR existed between the patients of the two groups. Larger stones were removed via SMP compared to those removed with MPCNL (2.0 vs. 1.5cm, P = 0.001). LOS for SMP patients was significantly lower than that for the MPCNL patients (2 and 6days, respectively, P<0.0001). The tubeless rate for SMP was significantly higher than that for MPCNL (100% vs. 0%, P<0.0001). Total complication rate of MPCNL was significantly higher than that of SMP (25.3% vs. 7.5%, P=0.006). No patient required blood transfusion, and septicaemia, and other serious complications did not occur. SMP is more effective than MPCNL for treating middle-sized upper urinary tract stones in children, and is associated with a shorter LOS and a higher tubeless rate.