Ultra-Mini-Percutaneous Nephrolithotomy for the Treatment of Upper Urinary Tract Stones Sized between 10-20 mm in Children Younger Than 8 Years Old
Vol. 17 No. 2 (2020),
16 March 2020
AbstractPurpose: With the invention of miniature devices, it has been advised to apply less aggressive methods for the management of upper urinary tract stones, especially in children. In the recent years, ultra-mini percutaneous nephrolithotomy (UMP) has been used for the treatment of upper urinary tract stones in order to perform surgeries with less complications and more acceptable outcomes. Results reported from different medical centers have been promising.
Materials and Methods: Twenty-two children aged less than 8 years old with upper urinary stones sized between 10-20 mm underwent UMP. Inclusion criteria was solitary unilateral kidney stone, stone size between 10-20 mm, normal renal function tests, absence of any congenital malformations, and history of previous ESWL failure. Data including age, sex, side of kidney involvement, size of stone, location of stone, duration of surgery, duration of hospitalization, stone composition, need for blood transfusion, damage to adjacent organs, postoperative fever, septicemia after surgery, need for narcotics, further need for a complementary method, stone-free rate, pre and post-operative hemoglobin levels, and urinary leakage from the access tract were extracted from patients' medical files and were recorded.
Results: The mean age (± standard deviation) of children was 5.22 (±1.57) years. Fourteen (63.6%) patients were male. Fifteen (68.2%) renal stones were located in the right kidney, and 82% of patients had pelvis stones. 13 (59%) patients’ stones were composed of calcium oxalate. Stone-free rate was 95.5%. In none of the cases urinary leakage, septicemia after surgery, injury to adjacent organs, and need for blood transfusions was reported.
Conclusion: Ultra-mini percutaneous nephrolithotomy is an efficient and safe method for treating urinary stones sized between 10-20 mm in children.
- Ultra-mini Percutaneous Nephrolithotomy
- Upper urinary stone less than 20 mm
- children under 8 years
Geary DF, Schaefer F. Comprehensive Pediatric Nephrology E-Book: Text with CD-ROM: Elsevier Health Sciences; 2008.
Tasian GE, Copelovitch L. Evaluation and medical management of kidney stones in children. The Journal of urology. 2014;192(5):1329-36.
VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, et al. Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. The Journal of urology. 2007;177(6):2300-5.
Sas DJ, Hulsey TC, Shatat IF, Orak JK. Increasing incidence of kidney stones in children evaluated in the emergency department. The Journal of pediatrics. 2010;157(1):132-7.
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh urology: expert consult premium edition: enhanced online features and print, 4-volume set: Elsevier Health Sciences; 2011.
Tekgül S. Ureteroscopy versus shock wave lithotripsy for renal calculi in children. The Journal of urology. 2011;185(4):1188-9.
Desai J, Solanki R. Ultra‐mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU international. 2013;112(7):1046-9.
Datta S, Solanki R, Desai J. prospective outcomes of ultra-mini percutaneous nephrolithotomy (ump): A consecutive single centre cohort study of 98 patients: P7. Bju International. 2015;115:18.
Lingeman J. Prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis; initial long-term follow up. Journal of Endourology. 1997;11(1):P2-5.
Sabnis RB, Jagtap J, Mishra S, Desai M. Treating renal calculi 1–2 cm in diameter with minipercutaneous or retrograde intrarenal surgery: a prospective comparative study. BJU international. 2012;110(8b):E346-E9.
Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M. The “all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. European Urology. 2011;59(6):1054-9.
Desai J, Zeng G, Zhao Z, Zhong W, Chen W, Wu W. A novel technique of ultra-mini-percutaneous nephrolithotomy: introduction and an initial experience for treatment of upper urinary calculi less than 2 cm. BioMed research international. 2013;2013.
Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. The Journal of urology. 2011;186(1):140-5.
Agrawal MS, Agarwal K, Jindal T, Sharma M. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal. Indian journal of urology: IJU: journal of the Urological Society of India. 2016;32(2):132.
Jones P, Bennett G, Aboumarzouk O, Griffin S, Somani B. Role of minimally invasive PCNL techniques: micro and ultra-mini PCNL (< 15Fr) in the paediatric population—a systematic review. J Endourol. 2017;10.
Tepeler A, Başıbüyük İ, Tosun M, Armağan A. The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones. Turkish journal of urology. 2016;42(4):261.
Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. European urology. 2007;51(4):899-906.
Skolarikos A, de la Rosette J. Prevention and treatment of complications following percutaneous nephrolithotomy. Current opinion in urology. 2008;18(2):229-34.
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