To evaluate the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP) in the treatment of pediatric kidney stones.
We retrospectively reviewed the records of 111 children with renal stones treated with SMP technique in four different centers between September 2014 and September 2015. The indications for SMP treatment in all these kids were either previously failed SWL or RIRS approaches or according to their parents' preferences. The size of nephrostomy tracts used in SMP system ranged from 10Fr to 14 Fr. The lithotripsy was performed using either a Holmium laser or pneumatic lithotripter. Perioperative and postoperative parameters along with operative data were recorded in detail and stone components were analyzed by infrared spectroscopy.
This study included 71 boys and 40 girls with a mean age of 3.90 ± 3.53 years (range 0.5 to 15). The mean stone burden was 1.4 ± 0.6 cm (range 0.8 to 4.8). Mean operative time was 39.4 ± 26.2 mins (range 7 to 105). The mean hemoglobin drop was 10.2 ± 7.1 g/L (range 0 to 25) and no transfusion was needed. Significant complications were observed in 17 (15.3%) children with 10 and 7 cases in Clavien grade I and grade II, respectively. Complete stone clearance on postoperative 1 day and 3-month follow up was 84.7% (94/111) and 90.1% (100/111), respectively. 95 (85.6%) children did not require any kind of catheters (total tubeless). The mean hospital stay was 2.7 ± 1.5 days (range 1 to 7).
Our preliminary data demonstrated well that with its safe and effective nature, SMP could be a feasible treatment option for the pediatric stone disease. Further randomized, controlled trials are still needed to prove the efficacy of SMP system in children particularly with larger stones.
Journal of endourology. 2016 Nov 07 [Epub ahead of print]
Yongda Liu, Wenqi Wu, Tuerxun Aierken, Yang Liu, Simayi Abulizi, Jinxing Huang, Batuer Abudukahaer, Yizhou Zhou, Jiawei Luo, Wen Zhong, Zhijian Zhao, Wei Zhu, Guohua Zeng
Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., Minimally Invasive Surgery center, The first affiliated Hospital of Guangzhou medical University, Urology , kangda Road 1#, , Haizhu District , Guangzhou, Guangdong, China , 510230 ; ., The First People, s Hospital of Kashi, Kashi, Xinjiang, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., The Xinjiang Uygur Autonomous Region people's Hospital, Department of Urology, Urumchi, Xinjiang, China ; ., Shache County People's Hospital, Department of Urology, Kashi, Xinjiang, China ; ., The First People' s Hospital of Kashi, Department of Urology, Kashi, Xinjiang, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China, Department of Urology, Guangzhou, Guangdong, China ; ., Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China , Department of Urology, Guangzhou, Guangdong, China ; .