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MINI PCNL in a Pediatric Population

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Abstract

Purpose

We report our initial experience of MINI percutaneous nephrolithotomy (PCNL) in a pediatric population using a miniature nephroscope through a 16F metal access sheath.

Methods

All pediatric patients who underwent PCNL from August 2007 to September 2010 using a 14F miniature nephroscope through a 16F metal access sheath for renal stone extraction were evaluated. Patients’ demographic details, procedural information, and posttreatment outcomes were prospectively documented.

Results

A total of 23 MINI PCNLs were performed on 23 kidneys of 12 patients whose ages ranged from 1.6 to 14.6 years. The median stone burden was 3.44 cm2, and there were 11 “Staghorn” stones. The procedure was primary via a single puncture in 19 kidneys and secondary using a preexisting nephrostomy tract in 4 kidneys. Access was successful in all primary and two secondary cases, for a total of success rate of 91.3 %. Stones were fragmented using a Holmium laser and/or lithoclast, and fragments were irrigated or sequentially removed by various stone grasping devices. The mean procedural X-ray screening time and total stone extraction period were 4.5 and 109.4 min, respectively. The primary stone free rate was 83.6 %, which increased to 90.5 % after treating the residual fragments. Postoperative hydrothorax developed in one patient, which required a chest drain. Symptoms of chest infection and positive urine culture were detected in one and two patients, respectively.

Conclusions

Our initial experience supports previous reports that MINI PCNL is safe and effective for the management of renal stones in children.

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References

  1. Ghazali S, Barratt TM, Williams DI (1973) Childhood urolithiasis in Britain. Arch Dis Child 48:291–295

    Article  PubMed  CAS  Google Scholar 

  2. Androulakakis PA, Barratt TM, Ransley PG et al (1982) Urinary calculi in children. A 5 to 15 year follow-up with particular reference to recurrent and residual stones. British J Urol 54:176–180

    Article  CAS  Google Scholar 

  3. Coward RJM, Peters CJ, Duffy PG, Corry D, Kellett MJ, Choong S, van’t Hoff WG (2003) Epidemiology of paediatric renal stone disease in the UK. Arch Dis Child 88:962–965

    Article  PubMed  CAS  Google Scholar 

  4. Newman DM, Coury T, Lingeman JE, Merta JH, Mosbaugh PG, Steele RE, Knapp PM (1986) Extracorporeal shockwave lithotripsy in children. J Urol 136:238–240

    PubMed  CAS  Google Scholar 

  5. Woodside JR, Stevens GF, Stark GL, Borden TA, Ball WS (1985) Percutaneous stone removal in children. J Urol 134:1166–1167

    PubMed  CAS  Google Scholar 

  6. Mor Y, Elmasry YE, Kellett MJ, Duffy PG (1997) The role of percutaneous nephrolithotomy in the management of paediatric renal calculi. J Urol 158:1319–1321

    Article  PubMed  CAS  Google Scholar 

  7. Jackman SV, Hedican SP, Peters CA, Docimo SG (1998) Percutaneous nephrolithotomyin infants and preschool age children: experience with a new technique. Urology 52:697–701

    Article  PubMed  CAS  Google Scholar 

  8. Zeren S, Satar N, Bayazit Y, Bayazit AK, Payasli K, Ozkeceli R (2002) Percutaneous nephrolithotomyin the management of paediatric renal calculi. J Endourol 16:75–78

    Article  PubMed  Google Scholar 

  9. Desai MR, Kukreja RA, Patel SH, Bapat SD (2004) Percutaneous nephrolithotomy for complex paediatric renal calculus disease. J Endourol 18:23–27

    Article  PubMed  Google Scholar 

  10. Badawy H, Salama A, Eissa M, Kotb E, Moro H, Shoukri I (1992) Percutaneous management of renal calculi: experience with percutaneous nephrolithotomy in 60 children. J Urol 162:1710–1713

    Article  Google Scholar 

  11. Callaway TW, Lingardh G, Basata S, Sylven M (1992) Percutaneous nephrolithotomy in children. J Urol 148:1067–1068

    PubMed  CAS  Google Scholar 

  12. Farhat WA, Kropp BP (2001) Surgical treatment of paediatric urinary stones. AUA update series 26:22–27

  13. Helal M, Black T, Lockhart J, Figueroa TE (1997) The Hickman peel-away sheath: alternative for paediatric percutaneous nephrolithotomy. J Endourol 11:171–172

    Article  PubMed  CAS  Google Scholar 

  14. Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW (1998) The ‘mini-perc’ technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 16:371–374

    Article  PubMed  CAS  Google Scholar 

  15. Irving HC (2005) Stone management-percutaneous access. In: Najmaldin A, Rothenberg S, Crabbe D, Beasley S (eds) Operative endoscopy and endoscopic surgery in infants and children. Arnold, London

    Google Scholar 

  16. Scuster TK, Smaldone MC, Averch TD, Ost MC (2009) Percutaneous nephrolithotomy in children. J Endourol 23:1699–1705

    Article  Google Scholar 

  17. Kapoor R, Solanki F, Singhania P, Andankar M, Pathak HR (2008) Safety and efficacy of percutaneous nephrolithotomy in the paediatric population. J Endourol 22:637–640

    Article  PubMed  Google Scholar 

  18. Nouralizadeh A, Basiri A, Javaherforooshzadeh A, Soltani MH, Tajali F (2009) Experience of percutaneous nephrolithotomy using adult size instruments in children less than 5 years old. J Pediatr Urol 5:351–354

    Article  PubMed  Google Scholar 

  19. Sung YM, Choo SW, Jeon SS, Shin SW, Park KB, Do YS (2006) The ‘mini-perc’ technique of percutaneous nephrolithotomy with a 14F peel-away sheath: 3-year results in 72 patients. Korean J Radiol 7:50–55

    Article  PubMed  Google Scholar 

  20. Wiesenthal JD, Ghiculete D, D’A Honey RJ, Pace KT (2011) A comparison of treatment modalities for renal calculi between 100 and 300 mm2: are shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy equivalent? J Endourol 25(3):481–485

    Article  PubMed  Google Scholar 

  21. Malcolm JB, Derweesh IH, Brightbill EK, Mehrazin R, DiBlasio CJ, Wake RW (2008) Tubeless percutaneous nephrolithotomy for complex renal stone disease: single center experience. Can J Urol 15(3):4072–4076 discussion 4076-4077

    PubMed  Google Scholar 

  22. Srirangam SJ, Darling R, Stopford M, Neilson D (2008) Contemporary practice of percutaneous nephrolithotomy: review of practice in a single region of the UK. Ann R Coll Surg Engl 90(1):40–44

    Article  PubMed  Google Scholar 

  23. Bayles A, Chitale S, Irving S, Burgess N (2007) Percutaneous nephrolithotomy. On behalf of the BAUS Section of Endourology http://www.baus.org.uk/Resources/BAUS/Documents/PDF%20Documents/Sections/Endourology/PCNL%20Audit%202007.pdf. Accessed 25 Sept 2011

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Acknowledgements

 

Conflict of interest

Drs. Wah, Kidger, Kennish, Irving, and Najmaldin have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Radiology, St. James’s University Hospital, Beckett Street, Leeds, LS9 7TF, UK

    Tze M. Wah, Steven Kennish & Henry Irving

  2. Department of Paediatric Urology, Clarendon Wing, Leeds General Infirmary, Leeds, UK

    Lizi Kidger & Azad Najmaldin

Authors
  1. Tze M. Wah
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  2. Lizi Kidger
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  3. Steven Kennish
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  4. Henry Irving
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  5. Azad Najmaldin
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Correspondence to Tze M. Wah.

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Wah, T.M., Kidger, L., Kennish, S. et al. MINI PCNL in a Pediatric Population. Cardiovasc Intervent Radiol 36, 249–254 (2013). https://doi.org/10.1007/s00270-012-0460-7

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  • DOI: https://doi.org/10.1007/s00270-012-0460-7

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