Ultra-mini-percutaneous nephrolithotomy in pediatric nephrolithiasis: Both low pressure and high efficiency

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dc.contributor.authorDede, Onur
dc.contributor.authorSancaktutar, Ahmet Ali
dc.contributor.authorDagguli, Mansur
dc.contributor.authorUtangac, Mazhar
dc.contributor.authorBas, Okan
dc.contributor.authorPenbegül, Necmettin
dc.date.accessioned2024-04-24T16:15:21Z
dc.date.available2024-04-24T16:15:21Z
dc.date.issued2015
dc.departmentDicle Üniversitesien_US
dc.description.abstractIntroduction The management of urolithiasis in children differs from adults because of anatomic and metabolic abnormalities. At present, various minimally invasive and invasive treatment strategies have been recommended to treat urinary tract Stones, including shock wave lithotripsy (SWL), standard percutaneous nephrolithotomy (PNL), mini-PNL, retrograde intrarenal surgery (RIRS), micro-PNL, and a new technique termed ultra-mini PNL (UMP). UMP is a new method for the treatment of kidney stones. The main difference between UMP and standard PNL or mini-PNL lies in the small access sheath and in its design. A 9.5F pediatric compact cystoscope was used (Figure). A major advantage of UMP is that it provides similar stone-free rates when compared with standard PNL, with lower intrarenal pressure than micro-PNL. Objective The aim of the study was to determine the applicability and safety of UMP in the treatment of pediatric kidney stones. Patients and methods We retrospectively reviewed the files of 39 kidney stones in children who had undergone UMP between May 2011 and October 2014. The indications for UMP included stones resistant to SWL, stones requiring repeated sessions of SWL, and stones size larger than 20 mm. Results The study included 17 females and 22 males, with a mean age of 5.8 +/- 4.6 years. The mean hemoglobin loss was 0.9 +/- 0.6 mg/dL and none of the patients required a blood transfusion. The complication rate of the PNL procedure was 15.3% (n = 6). Complete clearance was achieved in 32 patients (82%) with UMP monotherapy, which increased to 34% (87.1%) 4 weeks after the operation. Discussion Management of urolithiasis necessitates a balance between stone clearance and morbidity related to the procedure. SWL often leads to persistent residual stones. The developing RIRS can minimize the risks associated with bleeding and visceral injury, but sometimes the abnormal pelvicaliceal anatomy and poor imaging of the flexible ureteroscopy may impact its success rate and applications. It has been reported that PNL can be performed safely and effectively to achieve a higher stone-free rate; however, it has serious complications such as bleeding that requires blood transfusion in 11-14% of the cases with increased risk of kidney loss. The recent development of smaller sheaths allows tract formation with minimal damage to the renal parenchyma, thereby reducing procedure-related morbidity without diminishing its therapeutic efficacy. Conclusion The most important advantage of this surgical technique that has been developed is similar stone-free rates to standard PNL and lower intrarenal pressure than micro-PNL. Our experience supports that UMP is safe and effective for the management of renal stones in children.en_US
dc.identifier.doi10.1016/j.jpurol.2015.03.012
dc.identifier.issn1477-5131
dc.identifier.issn1873-4898
dc.identifier.issue5en_US
dc.identifier.pmid25964199
dc.identifier.scopus2-s2.0-85028242025
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1016/j.jpurol.2015.03.012
dc.identifier.urihttps://hdl.handle.net/11468/15768
dc.identifier.volume11en_US
dc.identifier.wosWOS:000365177200011
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofJournal of Pediatric Urology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectUltra-Mini Percutaneous Nephrolithotomyen_US
dc.subjectPediatric Nephrolithiasisen_US
dc.subjectTreatmenten_US
dc.titleUltra-mini-percutaneous nephrolithotomy in pediatric nephrolithiasis: Both low pressure and high efficiencyen_US
dc.titleUltra-mini-percutaneous nephrolithotomy in pediatric nephrolithiasis: Both low pressure and high efficiency
dc.typeArticleen_US

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