Safety and efficacy of tubeless percutaneous nephrolithotomy in children

Abstract

Objective To evaluate the safety and efficacy of tubeless percutaneous nephrolithotomy (tubeless PCNL) in children.Methods From May 2010 to December 2011,6 patients including 4 males and 2 females,with a mean age of 6.5 years old,were performed tubeless PCNI to remove renal or proximal ureteral calculi.Among the patients,3 were diagnosed with renal pelvic calculi,2 with upper ureteral calculi,and 1 with multiple renal calculi.Four patients had moderate hydronephrosis,and the other 2 had mild hydronephrosis.During PCNL,the calculi was cleared under the monitoring of C-arm fluoroscopy and B-ultrasound.Then the head end of the urethral catheter was adjusted to the center of renal pelvis.The peel-away sheath was removed when hemostat was confirmed.Results The calculi were cleared through a single tract in all cases.OOf the 6 cases,upper pole access was applied on 4,and middle pole access on the other 2.The average operation time was 35 min (range,30～75min).The mean hemoglobin reduction after surgery was 6.5 g/L (range,3～ 1 0 g/L).The postoperative hospital stay was 2 days.Significant complications including bleeding,collecting system perforation,and collateral injury to neighboring organ did not occur.Conclusions Tubeless percutaneous nephrolithotomy is safe and effective for the treatment of nephrolith in children. Key words: Renal calculi; Percutaneous nephrolithotomy