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Outcome of Mini-percutaneous Nephrolithotomy for Renal Stones in Infants and Preschool Children: A Prospective Study.
Urology 2015; 86(5):1019-26U

Abstract

OBJECTIVE

To assess the safety and efficacy of Miniperc for renal stones in preschool-age patients. To the best of our knowledge, this may be the first prospective study on this subject. Reports on Miniperc are still few and mostly retrospective using a sheath size of ≥ 18Fr, which is still relatively large for young children.

PATIENTS AND METHODS

From January 2012 to May 2013, Miniperc was performed for 26 children (≤ 6 years old) with renal calculi <5 cm through 14Fr sheath using a 9.5Fr semirigid ureteroscope with Holmium:yttrium-aluminum-garnet laser lithotripsy. Effects of different factors on operative time, complications, and stone-free rate (SFR) were compared using chi-square, Fischer exact, or Mann-Whitney tests as appropriate using SPSS v15.0.

RESULTS

Primary SFR, SFR after retreatment, and SFR after auxiliary extracorporeal shock wave lithotripsy (ESWL) were 77%, 85%, and 92%, respectively. Retreatment rate was 8%. Auxiliary ESWL was done in 11%. Complications were bleeding (8%), hematuria and blood transfusion (4%), renal pelvis perforation (4%), leakage (8%), and fever (15%). Operative time was significantly prolonged in multiple (>2) stones (P = .006), calyceal stones (P = .002), or stone size ≥ 30 mm (P = .022). SFR was significantly lower in children with >2 stones (P = .028) and increased stone size ≥ 30 mm (P = .014).

CONCLUSION

Miniperc is a safe and effective minimally invasive procedure for pediatric renal stones using 14Fr access sheath. SFR was significantly lower in children with >2 stones or increased stone size ≥ 30 mm. This was overcome by retreatment and auxiliary ESWL.

Authors+Show Affiliations

Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt. Electronic address: mohammedshemy@yahoo.com.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

26342318

Citation

Daw, Kareem, et al. "Outcome of Mini-percutaneous Nephrolithotomy for Renal Stones in Infants and Preschool Children: a Prospective Study." Urology, vol. 86, no. 5, 2015, pp. 1019-26.
Daw K, Shouman AM, Elsheemy MS, et al. Outcome of Mini-percutaneous Nephrolithotomy for Renal Stones in Infants and Preschool Children: A Prospective Study. Urology. 2015;86(5):1019-26.
Daw, K., Shouman, A. M., Elsheemy, M. S., Shoukry, A. I., Aboulela, W., Morsi, H. A., ... Eissa, M. A. (2015). Outcome of Mini-percutaneous Nephrolithotomy for Renal Stones in Infants and Preschool Children: A Prospective Study. Urology, 86(5), pp. 1019-26. doi:10.1016/j.urology.2015.08.019.
Daw K, et al. Outcome of Mini-percutaneous Nephrolithotomy for Renal Stones in Infants and Preschool Children: a Prospective Study. Urology. 2015;86(5):1019-26. PubMed PMID: 26342318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of Mini-percutaneous Nephrolithotomy for Renal Stones in Infants and Preschool Children: A Prospective Study. AU - Daw,Kareem, AU - Shouman,Ahmed M, AU - Elsheemy,Mohammed S, AU - Shoukry,Ahmed I, AU - Aboulela,Waseem, AU - Morsi,Hany A, AU - Badawy,Hesham, AU - Eissa,Mohamed A, Y1 - 2015/09/02/ PY - 2015/06/13/received PY - 2015/08/20/revised PY - 2015/08/21/accepted PY - 2015/9/7/entrez PY - 2015/9/8/pubmed PY - 2016/4/19/medline SP - 1019 EP - 26 JF - Urology JO - Urology VL - 86 IS - 5 N2 - OBJECTIVE: To assess the safety and efficacy of Miniperc for renal stones in preschool-age patients. To the best of our knowledge, this may be the first prospective study on this subject. Reports on Miniperc are still few and mostly retrospective using a sheath size of ≥ 18Fr, which is still relatively large for young children. PATIENTS AND METHODS: From January 2012 to May 2013, Miniperc was performed for 26 children (≤ 6 years old) with renal calculi <5 cm through 14Fr sheath using a 9.5Fr semirigid ureteroscope with Holmium:yttrium-aluminum-garnet laser lithotripsy. Effects of different factors on operative time, complications, and stone-free rate (SFR) were compared using chi-square, Fischer exact, or Mann-Whitney tests as appropriate using SPSS v15.0. RESULTS: Primary SFR, SFR after retreatment, and SFR after auxiliary extracorporeal shock wave lithotripsy (ESWL) were 77%, 85%, and 92%, respectively. Retreatment rate was 8%. Auxiliary ESWL was done in 11%. Complications were bleeding (8%), hematuria and blood transfusion (4%), renal pelvis perforation (4%), leakage (8%), and fever (15%). Operative time was significantly prolonged in multiple (>2) stones (P = .006), calyceal stones (P = .002), or stone size ≥ 30 mm (P = .022). SFR was significantly lower in children with >2 stones (P = .028) and increased stone size ≥ 30 mm (P = .014). CONCLUSION: Miniperc is a safe and effective minimally invasive procedure for pediatric renal stones using 14Fr access sheath. SFR was significantly lower in children with >2 stones or increased stone size ≥ 30 mm. This was overcome by retreatment and auxiliary ESWL. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/26342318/Outcome_of_Mini_percutaneous_Nephrolithotomy_for_Renal_Stones_in_Infants_and_Preschool_Children:_A_Prospective_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(15)00825-0 DB - PRIME DP - Unbound Medicine ER -