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A retrospective cohort study: evaluating the efficacy of standard versus tubeless percutaneous nephrolithotomy (PCNL) in pediatric patients up to 18 years old

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Abstract

Percutaneous nephrolithotomy (PCNL) is an endourological method applied as the standard or tubeless method for kidney stone treatment. In a retrospective cohort study, 88 surgery units involving 75 children up to 18 years old with kidney stones who underwent the surgery for 8 years in Shahid Beheshti and Boo-ali hospitals in Hamadan with one of the two methods of standard or tubeless PCNL were evaluated and compared considering the success rate of operation, hemoglobin, hematocrit drop, need for medications, need for blood transfusion, duration of surgery, and the length of hospital stay. Among the 88 units studied, 47 cases were operated with the standard PCNL and 41 cases by tubeless method. In children operated by standard and tubeless PCNL, the complete success rate of operation was 87.2% and 100% (P = 0.006), the need for blood transfusion was 2.1% and 0% (P = 1.00), the need for opioids was 27.7% and 14.6% (P = 0.134), the decrease in hemoglobin was − 1.82 ± 0.94 and -1.30 ± 0.98 mg/dl (P = 0.024), the decrease in hematocrit was − 5.40 ± 2.66 and -3.52 ± 3.11 mg/dL (P = 0.003), the mean surgery duration was 109.30 ± 53.27 and 101.46 ± 31.92 min (P = 0.414), the duration of postoperative hospitalization was 3.38 ± 1.76 and 2.46 ± 1.27 days (P = 0.007), and the frequency of fever was 23.4% and 7.3% (P = 0.04), respectively. The success rate of kidney stone surgery in children with the tubeless PCNL is higher than the standard method, and its complications are lower.

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The corresponding author can provide the data supporting the findings of this study upon reasonable request.

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Acknowledgements

We extend our sincere appreciation and gratitude to all those who participated and provided invaluable assistance in implementing the plan and collecting the data for this study. Their contributions are greatly acknowledged and appreciated. Also, the authors express their gratitude to the Clinical Research Development Unit of Imam Khomeini Hospital affiliated with the Ilam University of Medical Sciences.

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Authors and Affiliations

  1. Department of Urology, Ilam University of Medical Sciences, Ilam, Iran

    Kian Kiani

  2. Development Unit, Imam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran

    Kian Kiani

  3. Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

    Shahriar Amirhasani & Seyed Habibollah Mousavi-bahar

  4. Department of Community Medicine, Hamedan University of Medical Science, Hamadan, Iran

    Abbas Moradi

Authors
  1. Kian Kiani
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  2. Shahriar Amirhasani
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  3. Seyed Habibollah Mousavi-bahar
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  4. Abbas Moradi
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Contributions

Conception and design: KK; acquisition of data: ShA; analysis and interpretation of data: SHM; drafting of the manuscript and statistical analysis: AM; and critical revision: KK and ShA.

Corresponding author

Correspondence to Seyed Habibollah Mousavi-bahar.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Prior to enrolling in the study, all participants or their legal guardians were provided with detailed information about the study and its objectives. They were given the opportunity to ask questions and clarify any concerns. Informed written consent was obtained from all study participants or their legal guardians to ensure their voluntary participation in the research.

Research involving human and animal participants

This article is based on the urology residency course dissertation, which has been approved by the Vice-Chancellor for Research and Technology of Hamadan University of Medical Sciences. It is important to note that this study involved human participants and was conducted in accordance with the ethical guidelines set by the Hamadan University of Medical Sciences Ethics Committee (Ethics Committee Approval Number: IR.UMSHA.REC.1397.880).

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Kiani, K., Amirhasani, S., Mousavi-bahar, S.H. et al. A retrospective cohort study: evaluating the efficacy of standard versus tubeless percutaneous nephrolithotomy (PCNL) in pediatric patients up to 18 years old. Urolithiasis 52, 68 (2024). https://doi.org/10.1007/s00240-024-01540-z

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