Abstract
ABSTRACTObjectives:The present study was aim to evaluate the safety and efficacy of Mini-PNL to treat kidney stones in patients aged <3 years. This is the one of the largest series in the literature in this age group of patients.Material and methods:From May 2012 to April 2016, the medical records of 74 infant patients who underwent mini-PNL for renal stones were reviewed retrospectively. All infants were evaluated with the plain abdominal radiograph, urinary ultrasound, non-contrast computerized tomography and/or intravenous urogram. Pre-operative, intraoperative and post-operative data were analyzed.Results:A total of 74 infant (42 male, 32 female) with a mean age 21.5±8.2 (10-36) months were included in this study. The mean size of the stones was 22.0±5.9 (14-45) mm. A 17 Fr rigid pediatric nephroscope with a pneumatic intracorporeal lithotripsy were used through 20-22 Fr access sheath. The stone-free rate was 84.7% at 1 month after the operation. Mean operative time was 74.0 (40-140) min. Mean fluoroscopy screening time was as 4.3(3.1-8.6) min. Average hospitalization time was 3.8 (2-9) day. Auxiliary procedures were performed to 11(15.3%) patients (7 extracorporeal shock wave lithotripsy, 3 re- percutaneous nephrolitotomy, 1 retrograde intrarenal surgery). No major complication classified as Clavien IV-V observed in study group.Conclusions:Mini-PNL with pneumatic intracorporeal lithotripsy can be performed safely and effectively to manage kidney stones in infants with high stone free rate and low complications.
Highlights
Childhood urolithiasis is a major health problem in developing countries especially in endemic regions
The present study aims to evaluate the safety and efficacy of mini-PNL to treat kidney stones in patients aged
Auxiliary procedures were performed to 11(15.3%) patients (7 ESWL, 3 re- percutaneous nephrolitotomy (PCNL), 1 RIRS)
Summary
Childhood urolithiasis is a major health problem in developing countries especially in endemic regions. Children with kidney stone are classified as high-risk patients for recurrence and requirement of multiple interventions [3]. In this century, with the advancement of technology, minimal invasive treatment modalities such as extracorporeal shock wave therapy (ESWL), percutaneous nephrolitotomy (PCNL) (micro-, mini-), flexible ureteroscopy (f-URS) are routinely used for the treatment of pediatric renal stones [4]. According to the European Urology Guidelines (EAU) for the treatment of pediatric kidney stones, ESWL is the first treatment option for stones smaller than 2cm. Since the first series of mini-PCNL technique was published in 1998, mini-PCNL has reached higher stone free rates (SFR) in pediatric patients with lower complication rates [8]
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