Abstracts
To investigate the efficacy and safety of mini-percutaneous nephrolithotomy (mini-PCNL) under total ultrasonography in patients aged <3 years. Methods: We reviewed 56 patients (67 renal units) aged <3 years between August 2006 and December 2012 in our units, including 31 renal units with a single stone, 6 with staghorn stones, 10 with upper ureteral stones, and 20 with multiple stones. The mean age of the patients was 24 (range 6–36) months and the mean maximum stone diameter was 18.9 (range 10–32) mm. The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12–16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope. Forty-five patients with unilateral stones underwent a single procedure, and 11 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.9 (range 2.1–5) min, the mean operative time was 36.8 (range 20–88) min, the mean decrease in hemoglobin concentration was 8.7 (2–15) g/L, and the stone-free rate at hospital discharge was 92.5 %. The mean postoperative hospital stay was 7.1 (range 3–13) days. Post-procedure complications included fever (>38.5 °C) in four patients, and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed. Ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dogan HS, Tekgul S (2007) Management of pediatric stone disease. Curr Urol Rep 8:163–173
Lahme S (2006) Shockwave lithotripsy and endourological stone treatment in children. Urol Res Apr 34(2):112–117
Hesse A, Kruse R, Geilenkeuser WJ et al (2005) Quality control in urinary stone analysis: results of 44 ring trials (1980–2001). Clin Chem Lab Med 43(3):298–303
Zeng G, Zhao Z, Zhao Z et al (2012) Percutaneous nephrolithotomy in infants: evaluation of a single-center experience. Urology 80(2):408–411
Bodakci MN, Daggülli M, Sancaktutar AA et al (2014) Minpercutaneous nephrolithotomy in infants: a single-center experience in an endemic region in Turkey. Urolithiasis 42(5):427–433
Palmer LS (2006) Pediatric urologic imaging. Urol Clin North Am 33(3):409–423
Landau EH, Shenfeld OZ, Pode D et al (2009) Extracorporeal shock wave lithotripsy in prepubertal children: 22-year experience at a single institution with a single lithotriptor. J Urol 182(4 Suppl):1835–1839
Tan AH, Al-Omar M, Watterson JD et al (2004) Results of shockwave lithotripsy for pediatric urolithiasis. J Endourol 18(6):527–530
Straub M, Gschwend J, Zorn C (2010) Pediatric urolithiasis: the current surgical management. Pediatr Nephrol 25(7):1239–1244
Kapoor R, Solanki F, Singhania P et al (2008) Safety and efficacy of percutaneous nephrolithotomy in the pediatric population. J Endourol 22(4):637–640
Etemadian M, Maghsoudi R, Shadpour P et al (2012) Pediatric percutaneous nephrolithotomy using adult sized instruments: our experience. Urol J. Spring 9(2):465–471
Traxer O, Smith TG 3rd, Pearle MS et al (2001) Renal parenchymal injury after standard and mini percutaneous nephrostolithotomy. J Urol 165:1693–1695
Desai MR, Kukreja RA, Patel SH et al (2004) Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourol 18:23–27
Unsal A, Resorlu B, Kara C et al (2010) Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 76(1):247–252
Kumar R, Anand A, Saxena V et al (2011) Safety and efficacy of PCNL for management of staghorn calculi in pediatric patients. J Pediatr Urol 7(3):248–251
[No author listed]. International Commission on Radiological Protection (homepage on the Internet). Summary Recommendation [cited 2008 Feb 1]
Ministry of Health of the People’s Republic of China (2008) Medical treatment of infants affected by Sanlu melamine-contaminated milk powder. The Chinese Ministry of Health Bulletin. 15 October
Tzeng BC, Wang CJ, Huang SW et al (2011) Doppler ultrasound-guided percutaneous nephrolithotomy: a prospective randomized study. Urology 78(3):535–539
Guan N, Fan Q, Ding J et al (2009) Melamine-contaminated powdered formula and urolithiasis in young children. N Engl J Med 360(11):1067–1074
Choi SW, Kim KS, Kim JH et al (2014) Totally tubeless versus standard percutaneous nephrolithotomy for renal stones: analysis of clinical outcomes and cost. J Endourol 28(12):1487–1494
Elderwy AA, Gadelmoula M, Elgammal MA et al (2014) Percutaneous nephrolithotomy in children: A preliminary report. Urol Ann 6(3):187–191
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
We declare that we have no conflicts of interest.
Author Disclosure Statement
We have obtained the signed informed consent from the patient. The signed author statement and disclosure of conflicts of interest will be uploaded if necessary. All authors have reviewed this manuscript and agreed on submission to Urolithiasis.
Rights and permissions
About this article
Cite this article
Xiao, B., Hu, W., Zhang, X. et al. Ultrasound-guided mini-percutaneous nephrolithotomy in patients aged less than 3 years: the largest reported single-center experience in China. Urolithiasis 44, 179–183 (2016). https://doi.org/10.1007/s00240-015-0809-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00240-015-0809-x