Bilateral Single-session PCNL with Minimally Invasive Technique in Pediatric Nephrolithiasis
Urology Journal,
Vol. 21 No. 02 (2024),
24 March 2024
,
Page 114-120
https://doi.org/10.22037/uj.v20i.7767
Abstract
Purpose: To assess outcomes of bilateral single-session percutaneous nephrolithotomy (PCNL) with minimally
invasive techniques in pediatric population.
Materials and Methods: From August 2015 to July 2021, 45 children (including 12 infants) were treated with
bilateral single-session PCNL, which included miniPCNL (12-16-Fr) and Microperc (4.8-Fr). Patient, stone and
operation-related characteristics, stone-free rate (SFR) and complication rate (CR) were compared using ANOVA.
Independent predictors were determined using multivariate linear regression.
Results: The mean stone burden was 3.2 cm in sum diameter for both kidneys. For bilateral kidneys, the mean
operative time was 61.6min and SFR was 93.3%; CR was 53.3%, of which complications of Clavien grade 1 and
2 accounted for 46.7%. Bilateral Microperc, bilateral miniPCNL and Microperc plus miniPCNL was performed
in 19, 14 and 12 children respectively. Both irrigation volume and postoperative stay were less in groups with Microperc. Both SFRs and CRs were satisfactory for the three groups. Self-limiting hematuria represented the most
common complication of all cases (33.3%), especially in groups with miniPCNL. The stone burden was the only
independent predictor for operative time (P < .001) and the postoperative complication (P = .008). Children with
older age (P = .009), higher body mass index (P = .016) or a higher stone burden (P < .001) received larger irrigated
fluid volume. Microperc was associated with less irrigated fluid volume (P = .001). Children with Clavien grade 3
complications (P = .004) spent prolonged postoperative hospital stay.
Conclusion: With favourable SFR and acceptable CR, bilateral single-session PCNL with minimally invasive
techniques might be an effective and safe procedure for pediatric nephrolithiasis.
- Pediatric nephrolithiasis; bilateral single-session PCNL; Minimally invasive PCNL; Outcome
How to Cite
References
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