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Mini-percutaneous nephrolithotomy for pediatric complex renal calculus disease: one-stage or two-stage?

  • Urology - Original Paper
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Abstract

Objectives

To compare two different treatment strategies, one-stage and two-stage multi-tract mini-percutaneous nephrolithotomy (mt-mPCNL), for pediatric complex renal calculus disease.

Methods

Between the period of July 2016 and July 2018, a total of 36 children aged 15 years and younger, with complex renal calculi disease, who underwent total ultrasound-guided mt-mPCNL by a single experienced urologist were enrolled in our study. All patients were assigned either to Group 1 (n = 18) who received one-stage mt-mPCNL or Group 2 (n = 18) who received planned two-stage mt-mPCNL.

Results

The demographic data were comparable between the two groups. There were no serious complications (Modified Clavien Grade ≥ III) observed in either group. The stone -free rate (SFR), operation time, postoperative creatinine increase, and perioperative complication rates were similar in both groups (P = 0.603, 0.818, 0.161, and 0.402, respectively). The postoperative hospital stay (5.8 days vs. 7.4 days) and cost (17373.3 CNY vs. 23717.1 CNY) were statistically less in Group 1. Group 2 had significantly less total estimated blood loss (70.6 ml vs. 130.0 ml, P < 0.001). The operation time of two cases in Group 1 with perioperative sepsis or systemic inflammatory response syndrome (SIRS) was more than two hours.

Conclusions

Our preliminary results indicated that both one-stage and two-stage mt-mPCNL were safe and effective for pediatric complex renal calculi. Two-stage mt-mPCNL could significantly reduce blood loss; while one-stage mt-mPCNL could significantly decrease the length and costs of hospitalization. We also suggest that the planned two-stage mt-mPCNL should be applied in children with estimated operation time more than two hours.

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Funding

Funding was provided by the Natural Science Foundation of Hunan Province 2018JJ3808 (to Dr. Yuan).

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Authors and Affiliations

  1. Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China

    Ben-Yi Fan, Harripersaud Chand, Wen-Jun Liu & Jun-Bin Yuan

  2. Department of Blood Transfusion, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China

    Lan Gu

Authors
  1. Ben-Yi Fan
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  2. Lan Gu
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  3. Harripersaud Chand
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  4. Wen-Jun Liu
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  5. Jun-Bin Yuan
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Corresponding author

Correspondence to Jun-Bin Yuan.

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The authors have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from the parents of all individual participants included in the study.

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Fan, BY., Gu, L., Chand, H. et al. Mini-percutaneous nephrolithotomy for pediatric complex renal calculus disease: one-stage or two-stage?. Int Urol Nephrol 51, 201–206 (2019). https://doi.org/10.1007/s11255-018-2054-z

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  • DOI: https://doi.org/10.1007/s11255-018-2054-z

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