Category: Clinical Stones: PCNL

MP9-4 - Mini-Percutaneous Nephrolithotomy(MPCNL) in Pediatric Age Group

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : Nowdays, Renal calculi is a common problem in children. ESWL is the first choice in this age group, but sometimes other interventions may be indicated. In such cases PCNL seems the less invasive and more safe option than open surgery. We evaluated the results and complications of the pediatric MPCNL in our referral training center.


Methods :

Between September 2002 and March 2018,a total of 107 children, who had failure of and/or their parents refuse SWL underwent MPCNL(15 Fr). The procedure was done under general anesthesia, in prone position, with ureteral catheter 3 or4 F,diluted contrast injection and fluoroscopic or ultrasonographic guided nephrostomy by Chiba needle 18G.Tract dilation performed with Alken telescopic dilators. Nephroscopy were done with 15 Fr. nephroscope. Lithotripsy was done with pneumatic lithoclast and Saline solution used as irrigation. Nephrostomy tube was inserted in 21 with ureteral stent,tubeless(No nephrostomy) in 59 and totally tubeless in 27.Ureteral stent and Foley catheter removed 12-24 hours after operation.


Results :

Of total 107 patients,64 were boys,43 girls, with mean age 8.6 years(14months-15years) with renal stone=>20mm. Mean operation time was 60min(35-105) and radiation 0.5 min(0.2-1.4).97 were stone-free,5 patients had residual fragment less than 5mm, passed spontaneously in 2 weeks after operation,3 underwent second look nephroscopy, and 2 ureteroscopy for migrated stone fragments to distal ureter.Postoperatively,15 patients developed low grade  fever,1 sepsis,4 transfusion,and 2 raising of normal creatinine which improved with conservative management.


Conclusions :

MPCNL is recommended as an alternative option for treatment of the nephrolithiasis in children.

Mohammad Mehdi Hosseini

Associate Professor of Urology,Director,Minimal Invasive&Stone Unit,Urology Dept.,
Shiraz Nephrology-Urology Research Center,Shiraz University of Medical Sciences
Shiraz, Fars, Iran

Ali Eslahi

Shiraz Nephrology-Urology Research Center,Shiraz University of Medical Sciences
Shiraz, Fars, Iran

Mitra Basiratnia

Shiraz Nephrology-Urology Research Center,Shiraz University of Medical Sciences
Shiraz, Fars, Iran