Objective: In this study, we present the results of pediatric patients under 18 years of age who underwent standard percutaneous nephrolithot- omy (PNL), mini percutaneous nephrolithotomy (mini-PNL), ultra-mini percutaneous nephroli- thotomy (UMP) and micro percutaneous nephro- lithotomy (micro-PNL) procedures in our clinic.
Material and Methods: The data of 272 pa- tients were reviewed retrospectively who under the age of 18 and underwent different PNL proce- dures for the treatment of kidney stones between March 2011 and October 2015. According to the dilatation diameter applied in the operation pa- tients were divided into four groups as standard PNL (30 Fr-24 Fr) (Group 1), mini-PNL (20 Fr-16
Fr) (Group 2), UMP (14 Fr-12 Fr) (Group 3) and micro- PNL (4.8 Fr) (Group 4).
Results: 73 patients (Group 1), 75 patients (Group 2), 78 patients (Group 3) with UMP, 46 patients (Group 4) who were under 18 years of age and were included in the study due to renal stone. Mean operation time was; 56.3 ± 21.6 min in Group 1, 49.9 ± 15.3 min in Group 2, 57.3 ±
16.2 min in Group 3, 61.7 ± 22.6 min in Group 4 (p = 0.006). Duration of the scopy was 1.7 ± 1.1 min in Group 1, 1.5 ± 0.9 min in Group 2, 2.3 ± 1.3 min in Group 3, 1.6 ± 1.2 min in Group 4 (p <0.001). The decrease in hemoglobin content was 1.4 ± 1.5 gr / dL in Group 1, 1.1 ± 1.2 gr / dL in Group 2, 0.8 ± 0.9 gr / dL in Group 3, Group 4 0.5 ± 0.9 gr / dL (p <0.001). Although success rates were different result of the first intervention, after additional interven- tions the stone-free rate was 61 patients (83.6%) in Group 1, 70 patients (93.3%) in Group 2, and 66
patients (84.6%) in Group 3, 41 patients (89.1%) in Group 4 and we achieved to similar success rates between groups (p = 0.093).
Conclusions: In our study, despite the similar success and complication rates of different PNL procedures in the pediatric patient group under 18 years; hemorrhage was lower in UMP and micro-PNL. In this age group, similar success and efficacy were obtained with lower bleeding rate by using miniature instruments during accessories, dilatation and fragmentation.
Keywords: Percutaneous nephrolithotomy, Mini-PNL, Ul- tra-mini PNL, Micro-PNL, Pediatric nephrolithiasis
Abstract
Objective: In this study, we present the results of pediatric patients under 18 years of age who underwent standard percutaneous nephrolithot- omy (PNL), mini percutaneous nephrolithotomy (mini-PNL), ultra-mini percutaneous nephroli- thotomy (UMP) and micro percutaneous nephro- lithotomy (micro-PNL) procedures in our clinic.
Material and Methods: The data of 272 pa- tients were reviewed retrospectively who under the age of 18 and underwent different PNL proce- dures for the treatment of kidney stones between March 2011 and October 2015. According to the dilatation diameter applied in the operation pa- tients were divided into four groups as standard PNL (30 Fr-24 Fr) (Group 1), mini-PNL (20 Fr-16
Fr) (Group 2), UMP (14 Fr-12 Fr) (Group 3) and micro- PNL (4.8 Fr) (Group 4).
Results: 73 patients (Group 1), 75 patients (Group 2), 78 patients (Group 3) with UMP, 46 patients (Group 4) who were under 18 years of age and were included in the study due to renal stone. Mean operation time was; 56.3 ± 21.6 min in Group 1, 49.9 ± 15.3 min in Group 2, 57.3 ±
16.2 min in Group 3, 61.7 ± 22.6 min in Group 4 (p = 0.006). Duration of the scopy was 1.7 ± 1.1 min in Group 1, 1.5 ± 0.9 min in Group 2, 2.3 ± 1.3 min in Group 3, 1.6 ± 1.2 min in Group 4 (p <0.001). The decrease in hemoglobin content was 1.4 ± 1.5 gr / dL in Group 1, 1.1 ± 1.2 gr / dL in Group 2, 0.8 ± 0.9 gr / dL in Group 3, Group 4 0.5 ± 0.9 gr / dL (p <0.001). Although success rates were different result of the first intervention, after additional interven- tions the stone-free rate was 61 patients (83.6%) in Group 1, 70 patients (93.3%) in Group 2, and 66
patients (84.6%) in Group 3, 41 patients (89.1%) in Group 4 and we achieved to similar success rates between groups (p = 0.093).
Conclusions: In our study, despite the similar success and complication rates of different PNL procedures in the pediatric patient group under 18 years; hemorrhage was lower in UMP and micro-PNL. In this age group, similar success and efficacy were obtained with lower bleeding rate by using miniature instruments during accessories, dilatation and fragmentation.
Keywords: Percutaneous nephrolithotomy, Mini-PNL, Ul- tra-mini PNL, Micro-PNL, Pediatric nephrolithiasis