PD13-09 MICRO VERSUS MINI PERCUTANEOUS NEPHROLITHOTOMY FOR THE TREATMENT OF PEDIATRIC KIDNEY STONE DISEASE

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy I1 Apr 2015PD13-09 MICRO VERSUS MINI PERCUTANEOUS NEPHROLITHOTOMY FOR THE TREATMENT OF PEDIATRIC KIDNEY STONE DISEASE Tuna Karatag, Abdulkadir Tepeler, Mesrur Selcuk Silay, Mehmet Nuri Bodakci, Ibrahim Buldu, Mansur Daggulli, Namik Kemal Hatipoglu, Mustafa Okan Istanbulluoglu, and Abdullah Armagan Tuna KaratagTuna Karatag More articles by this author , Abdulkadir TepelerAbdulkadir Tepeler More articles by this author , Mesrur Selcuk SilayMesrur Selcuk Silay More articles by this author , Mehmet Nuri BodakciMehmet Nuri Bodakci More articles by this author , Ibrahim BulduIbrahim Buldu More articles by this author , Mansur DaggulliMansur Daggulli More articles by this author , Namik Kemal HatipogluNamik Kemal Hatipoglu More articles by this author , Mustafa Okan IstanbulluogluMustafa Okan Istanbulluoglu More articles by this author , and Abdullah ArmaganAbdullah Armagan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1073AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An increasing overall incidence of pediatric nephrolithiasis has been mentioned in current population-based studies. The current refinements in equipment such as smaller sheaths, optic puncture systems have been suggesting that PNL procedures might be performed with minimal injury to the pediatric kidney stones without reducing the effectiveness. we aimed to present the feasibility and safety of microperc in the treatment of pediatric renal stones based on comparison with mini-percutaneous nephrolithotomy (miniperc). METHODS The patients under an age of 18 who underwent percutaneous nephrolithotomy (PNL) for renal stones in size of 10 to 30 mm between August 2011 and March 2014 in three referral centers were reviewed retrospectively. The patients were classified in two groups according to the tract size: microperc (Group-1) and miniperc (Group-2). Demographics such as age, stone size and location, and perioperative parameters (fluoroscopy and operation time, hemoglobin drop, stone-free and complication rates) were retrospectively analyzed and compared by using a database system. RESULTS A total of 138 patients were classified as Group-1 (n: 59) and Group-2 (n: 79) according to the PNL technique. The mean age of the patients was 7.98±5.04 in Group-1 and 9.73±4.91 in Group-2 (p=0,068). Stone free rates were similar (81.3% vs.78.4%, p=0.318). The mean operation and fluoroscopy times were 57.0±31.2 minutes and 133.3±90.7 seconds in Group-1 and 71.9±36.7 minutes and 238.2±159.9 seconds in Group-2 (p<0.001 and p<0.001). We found no statistically significant difference in mean hemoglobin drop (p=0.504), however, the difference of average hospitalization times was significant (43.3±15.7 and 72.7±32.8 hours, p<0.001). There was also no statistically significant difference regarding overall complication rates (p=0.084). CONCLUSIONS Our present study demonstrates that microperc may be considered as an alternative to miniperc with comparable outcomes for the treatment of small sized kidney stones in pediatric population. Table 1. Demographic values of the patients Micro-PNL (Group-1) Mini-PNL (Group-2) p N 59 79 Male / Female 32/27 32/47 Mean age (years) 7.98±5.04 9.73±4.91 0.068 Mean stone size (mm²) 186.4±138.2 344.1±285.1 <0.001 Previous treatment history∗(n, %) 23/ 59 (39.9) 29/79 (36.7) 0.295 ∗ SWL and/or RIRS Table 2. Comparison of postoperative outcomes Micro-PNL Mini-PNL p Operative time (minutes) 57.0±31.2 71.9±36.7 <0.001 Fluoroscopy time (seconds) 133.3±90.7 238.2±159.9 <0.001 Hospitalization (hours) 43.3±15.7 72.7±32.8 <0.001 Hemoglobin drop (g/dL) 1.06±1.90 0.85±0.89 0.504 Stone free rate (n, %) 48/59 (81.3) 62/79 (78.4) 0.318 Complications (n, %) 3 (5.1) 11 (12.9) 0.084 Urinary tract infection (Clavien I) - - Renal colic requiring D-J stent insertion (Clavien III) 2 1 Hemorrhage∗ - 7 Saline extravasation requiring abdominal drainage (Clavien IIIa) 1 - Pelvic perforation - 1 Fever - 2 ∗ Needed to blood transfusion © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e265 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tuna Karatag More articles by this author Abdulkadir Tepeler More articles by this author Mesrur Selcuk Silay More articles by this author Mehmet Nuri Bodakci More articles by this author Ibrahim Buldu More articles by this author Mansur Daggulli More articles by this author Namik Kemal Hatipoglu More articles by this author Mustafa Okan Istanbulluoglu More articles by this author Abdullah Armagan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...