Flank-free Modified Supine Percutaneous Nephrolithotomy in Pediatric Age Group

Modified tubeless minimally invasive percutaneous nephrolithotomy for management of renal stones in children: A single-centre experience

“…On the other hand, Wah et al [18] reported a primary SFR of 83.6%, probably higher than our present study due to the use of a paediatric nephroscope and laser lithotripsy for stone disintegration, which increased to 91.3% after treating the residual fragments; whilst in 8.7% there was a failure to establish a satisfactory PCNL tract. Desoky et al [20] reported a SFR of 90.9%, which was higher than our present study most probably due to the larger diameter of tract (20 F) and the use of laser lithotripsy for stone disintegration. D'Souza et al [19] reported a primary SFR of 90%, which was again higher than our present study and most probably due to using a 12-F mini-nephroscope and laser lithotripsy with dusting settings used during lasering.…”

“…Whilst, D'Souza et al [19] reported a shorter mean operative time of 58 min, due to use of holmium yttrium-aluminium-garnet (YAG) laser for stone disintegration in 12 of 20 cases, and they studied children with smaller stones (median stone burden 1.36 cm). On the other hand, Desoky et al [20] reported a mean operative time of 65.1 min, which was also shorter than our present study as they operated all cases in the supine position, which avoids time loss during the change of patient position to the prone after ureteric catheterisation. The fluoroscopy time is commonly related to operative time, our mean (SD) fluoroscopy time was 7.68 (2.21) min, which is similar to that reported by other studies [18].…”

“…This agrees with the Domenech et al [7] study that reported a median (range) hospital stay of 3 (2-4) days and Chung et al [6] who found that the modified tubeless group had a mean (SD) of 5.9 (2.7) days, which was shorter than the standard PCNL at 6.8 (2.9) days. On the other hand, our present mean hospital stay was shorter than other studies reporting on conventional mini-PCNL such as Wah et al [18], who reported a mean (range) hospital stay of 4.78 (2-11) days, D'Souza et al [19] reported a mean hospital stay of 3 days, and Desoky et al [20] reported a mean (SD; range) hospital stay of 4.4 (0.9; 3.2-5.9) days.…”

“…Likewise, other studies of mini-PCNL in children, such as Wah et al [18] reported that one patient (4.8%) developed hydrothorax in which they used a supracostal approach, one patient (4.8%) had a chest infection, and two patients (9.6%) had positive urine cultures but no cases needed blood transfusion. Desoky et al [20] reported that one patient (4.55%) needed a blood transfusion; postoperative urinoma occurred in two patients (9.1%) and resolved with a JJ stent and conservative measures; postoperative fever occurred in four patients (18.2%). D'Souza and Paul [19] reported that one child (5%) developed postoperative sepsis, one child (5%) developed a postoperative fever, and two children (10%) needed a blood transfusion.…”

“…In that study of 80 children, standard PCNL was performed in 50 kidneys and mini-PCNL in 40 kidneys, as 10 cases had bilateral stones, the blood transfusion rate was 6% in the standard PCNL group, with no bleeding in the mini-PCNL group. The Dongol et al [21] study on standard PCNL in 25 children reported a blood transfusion rate of 12%, higher than the transfusion rate in mini-PCNL studies [18][19][20].…”