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Ultra-mini-PCNL using the urological Dyna-CT in small infants: a single-center experience

  • Urology - Original Paper
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Abstract

Purpose

To analyze and share our experience with ultra-mini-PCNL using the urological Dyna-CT in small infants.

Methods

A retrospective analysis was performed on all infants younger than 3 years of age who underwent ultra-mini-PCNL at our institution since 2016. Operating time, fluoroscopy time, dose area product (DAP), stone-free status, intra- and postoperative complications and the duration of hospital stay were analyzed.

Results

A total of nine interventions conducted on eight children were evaluated. The mean age of infants was 22.8 ± 11.9 months. The mean operation time and the mean fluoroscopy time were 119.2 ± 51.8 min, and 190.4 ± 93.8 s, respectively. The mean DAP was 11.4 ± 6.9 μGym2 and the stone clearance at 3 months was 87.5%. No major postoperative complications were assessed, and no transfusion was given. The mean hospital stay was 4 (IQR 3–6) days.

Conclusion

Ultra-mini-PCNL utilizing the urological Dyna-CT can safely and effectively be performed in small infants with kidney stones. In this setting, the urological Dyna-CT allows for a very low radiation exposure.

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Data availability

The data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants. But, the data are available from the corresponding author B.G. (britta.gruene@umm.de) upon reasonable request.

References

  1. Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD (2012) Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol 188:247–252

    Article  Google Scholar 

  2. Wang H-HS, Wiener JS, Lipkin ME, Scales CD, Ross SS, Routh JC (2015) Estimating the nationwide, hospital based economic impact of pediatric urolithiasis. J Urol 193:1855–1859

    Article  Google Scholar 

  3. Long CJ, Srinivasan AK (2015) Percutaneous nephrolithotomy and ureteroscopy in children. Urol Clin North Am 42:1–17

    Article  Google Scholar 

  4. Ang AJS, Sharma AA, Sharma A (2020) Nephrolithiasis: approach to diagnosis and management. Indian J Pediatr 87:716–725

    Article  Google Scholar 

  5. Tekgül S, Stein R, Bogaert G, Nijman RJM, Quaedackers J, t’ Hoen L et al (2021) European association of urology and European society for paediatric urology guidelines on paediatric urinary stone disease. Eur Urol Focus. https://doi.org/10.1016/j.euf.2021.05.006

    Article  PubMed  Google Scholar 

  6. Guven S, Frattini A, Onal B, Desai M, Montanari E, Kums J, CROES PCNL Study Group et al (2013) Percutaneous nephrolithotomy in children in different age groups: data from the clinical research office of the endourological society (CROES) Percutaneous nephrolithotomy global study: the CROES PCNL global study: children in different age groups. BJU Int 111:148–156

    Article  Google Scholar 

  7. He Q, Xiao K, Chen Y, Liao B, Li H, Wang K (2019) Which is the best treatment of pediatric upper urinary tract stones among extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery: a systematic review. BMC Urol 19:98

    Article  CAS  Google Scholar 

  8. Jia H, Li J, Liu B, Zhang P, Yusufu A, Nan Y et al (2021) Comparison of super-mini-PCNL and flexible ureteroscopy for the management of upper urinary tract calculus (1–2 cm) in children. World J Urol 39:195–200

    Article  Google Scholar 

  9. Goodman TR, Mustafa A, Rowe E (2019) Pediatric CT radiation exposure: where we were, and where we are now. Pediatr Radiol 49:469–478

    Article  Google Scholar 

  10. Fahmy A, Elgebaly O, Youssif M (2020) Fluoroscopic imaging optimization in children during percutaneous nephrolithotrispy. J Pediatr Urol 16:625.e1-625.e6

    Article  Google Scholar 

  11. Michel MS, Ritter M, Schönberg S, Häcker A, Weisser G (2012) Das urologische Dyna-CT: urologische schnittbildgebung auf einem neu entwickelten urologischen Interventionstisch. Urologe 51:857–861

    Article  CAS  Google Scholar 

  12. Michel MS, Ritter M, Wertz H, Schönberg S, Häcker A, Weisser G (2014) The Urological Dyna-CT: ex vivo feasibility study of interventional cross-sectional imaging in the endourological operation room. World J Urol 32:277–280

    Article  CAS  Google Scholar 

  13. Ritter M, Rassweiler M-C, Michel MS (2015) The Uro Dyna-CT enables three-dimensional planned laser-guided complex punctures. Eur Urol 68:880–884

    Article  Google Scholar 

  14. Preston DL, Cullings H, Suyama A, Funamoto S, Nishi N, Soda M et al (2008) Solid cancer incidence in atomic bomb survivors exposed in utero or as young children. JNCI J Natl Cancer Inst 100:428–436

    Article  Google Scholar 

  15. Ristau BT, Dudley AG, Casella DP, Dwyer ME, Fox JA, Cannon GM et al (2015) Tracking of radiation exposure in pediatric stone patients: the time is now. J Pediatr Urol 11:339.e1-339.e5

    Article  CAS  Google Scholar 

  16. Pelit ES, Atis G, Kati B, Akin Y, Çiftçi H, Culpan M et al (2017) Comparison of mini-percutaneous nephrolithotomy and retrograde intrarenal surgery in preschool-aged children. Urology 101:21–25

    Article  Google Scholar 

  17. Chen Y, Deng T, Duan X, Zhu W, Zeng G (2019) Percutaneous nephrolithotomy versus retrograde intrarenal surgery for pediatric patients with upper urinary stones: a systematic review and meta-analysis. Urolithiasis 47:189–199

    Article  Google Scholar 

  18. Karatag T, Tepeler A, Silay MS, Bodakci MN, Buldu I, Daggulli M et al (2015) A comparison of 2 percutaneous nephrolithotomy techniques for the treatment of pediatric kidney stones of sizes 10–20 mm: microperc vs miniperc. Urology 85:1015–1018

    Article  Google Scholar 

  19. Unsal A, Resorlu B, Kara C, Bozkurt OF, Ozyuvali E (2010) Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 76:247–252

    Article  Google Scholar 

  20. Pelit ES, Kati B, Çanakci C, Sağir S, Çiftçi H (2017) Outcomes of miniaturized percutaneous nephrolitotomy in infants: single centre experience. Int Braz J Urol 43:932–938

    Article  Google Scholar 

  21. Bodakci MN, Daggülli M, Sancaktutar AA, Söylemez H, Hatipoglu NK, Utangaç MM et al (2014) Minipercutaneous nephrolithotomy in infants: a single-center experience in an endemic region in Turkey. Urolithiasis 42:427–433

    Article  Google Scholar 

  22. Telli O, Haciyev P, Karimov S, Sarici H, Karakan T, Ozgur BC et al (2015) Does previous stone treatment in children generate a disadvantage or just the opposite? Urolithiasis 43:141–145

    Article  Google Scholar 

  23. Lazarus MS, Taragin BH, Malouf W, Levin TL, Nororis E, Schoenfeld AH et al (2019) Radiation dose monitoring in pediatric fluoroscopy: comparison of fluoroscopy time and dose–area product thresholds for identifying high-exposure cases. Pediatr Radiol 49:600–608

    Article  Google Scholar 

  24. Bayram Ilikan G, Karabulut B, Tiryaki HT (2021) Can ultrasound guidance reduce radiation exposure significantly in percutaneous nephrolithotomy in pediatric patients? Urolithiasis 49:173–180

    Article  Google Scholar 

  25. Hanna L, Walmsley BH, Devenish S, Rogers A, Keoghane SR (2015) Limiting radiation exposure during percutaneous nephrolithotomy. J Endourol 29:526–530

    Article  Google Scholar 

  26. Hernanz-Schulman M, Goske MJ, Bercha IH, Strauss KJ (2011) Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. Am J Roentgenol 197:475–481

    Article  Google Scholar 

  27. Wang W, Ge Y, Wang Z, Wang L, Li J, Tian Y (2019) Comparing micropercutaneous nephrolithotomy and retrograde intrarenal surgery in treating 1–2 cm solitary renal stones in pediatric patients younger than 3 years. J Pediatr Urol 15:517.e1-517.e6

    Article  CAS  Google Scholar 

  28. Chimenz R, Cannavò L, Viola V, Di Benedetto V, Scuderi MG, D’Angelo G et al (2019) Pediatric urolithiasis. J Biol Regul Homeost Agents 33:39–44 (Special issue: focus on pediatric nephrology)

    CAS  PubMed  Google Scholar 

  29. Grivas N, Thomas K, Drake T, Donaldson J, Neisius A, Petřík A et al (2020) Imaging modalities and treatment of paediatric upper tract urolithiasis: a systematic review and update on behalf of the EAU urolithiasis guidelines panel. J Pediatr Urol 16:612–624

    Article  Google Scholar 

  30. Jones P, Bennett G, Aboumarzouk OM, Griffin S, Somani BK (2017) Role of minimally invasive percutaneous nephrolithotomy techniques—micro and ultra-mini PCNL (<15F) in the pediatric population: a systematic review. J Endourol 31:816–824

    Article  Google Scholar 

  31. Dağgülli M, Sancaktutar AA, Dede O, Utanğaç MM, Bodakçi MN, Penbegül N et al (2015) Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience. Urolithiasis 43:507–512

    Article  Google Scholar 

  32. Lai L-L, See M-H, Rampal S, Ng K-S, Chan L (2019) Significant factors influencing inadvertent hypothermia in pediatric anesthesia. J Clin Monit Comput 33:1105–1112

    Article  Google Scholar 

  33. Sharifiaghdas F, Tabibi A, Nouralizadeh A, Sotoudeh M, Ayanifard M, Pakmanesh H et al (2021) Our experience with totally ultrasonography-guided percutaneous nephrolithotomy in children. J Endourol 35:749–752

    Article  Google Scholar 

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Acknowledgements

We thank the patients for participating in the study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Urology, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Britta Grüne, Marie-Claire Rassweiler-Seyfried, Kim Müller, Philipp Nuhn, Maurice Stephan Michel & Jonas Herrmann

  2. Center for Pediatric, Adolescent and Reconstructive Urology, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Nina Younsi & Raimund Stein

Authors
  1. Britta Grüne
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  2. Marie-Claire Rassweiler-Seyfried
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  3. Kim Müller
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  4. Philipp Nuhn
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  5. Maurice Stephan Michel
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  6. Nina Younsi
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  8. Jonas Herrmann
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Contributions

BG: conception, performance of work, interpretation and analysis of data, writing the article. MCR-S: performance of work, interpretation or analysis of data, editing the manuscript. KM: performance of work, editing the manuscript. PN: supervision, editing the manuscript. MSM: supervision, editing the manuscript. NY: supervision, editing the manuscript. RS: supervision, editing the manuscript. JH: conception, supervision, interpretation of data, writing the article, editing the manuscript. All authors drafted the work or revised it critically for important intellectual content. All authors approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Jonas Herrmann.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

Ethical approval was obtained (2020-837-AF 11 Ethics committee of the Medical Faculty of Mannheim, University of Heidelberg).

Consent to participate

All procedures were in accordance with the ethical standards of the institutional research committee and with the Helsinki declaration and its later amendments or comparable ethical standards. For the present retrospective data analysis, written informed consent was not obtained from the parents or guardians of the study participants prior to study inclusion which was approved by the ethics committee.

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Grüne, B., Rassweiler-Seyfried, MC., Müller, K. et al. Ultra-mini-PCNL using the urological Dyna-CT in small infants: a single-center experience. Int Urol Nephrol 54, 979–984 (2022). https://doi.org/10.1007/s11255-022-03150-3

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  • DOI: https://doi.org/10.1007/s11255-022-03150-3

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