Safety and Efficacy of Mini Percutaneous Nephrolithotomy Using Smaller Nephroscope for Kidney Stones in Children
DOI:
https://doi.org/10.51985/Keywords:
Percutaneous Nephrolithotomy; Nephrolithiasis; Pediatrics; Minimally Invasive Surgical Procedures; Lithotripsy; Kidney Calculi; Treatment OutcomeAbstract
Objective: To evaluate the safety and effectiveness of mini percutaneous nephrolithotomy (mini PCNL) with a smaller nephroscope in children aged 12 years and under with kidney stones
Study Design and Setting: It is a Prospective Cohort Study conducted at the department of Paediatric Urology, Bahawal Victoria Hospital Bahawalpur from 11th August 2020 to 10th August 2024.
Methodology: This study included 52 children (=12 years) with kidney stones =2.5 cm. Exclusions were children with non-functional kidneys, positive urine cultures, or coagulation disorders. After obtaining parental consent and assessing anaesthesia fitness, MPCNL was performed under general anaesthesia. A rigid 8/9.8 Fr nephroscope, 12 Fr amplatz sheath, and 1.5 mm pneumatic lithoclast probe were used. A supra-costal tract (above the 12th rib) was made in 36 patients and sub-costal in 16. Postoperative care included nephrostomy tube, ureteric catheter, and set tube removal protocol. Outcome measures included operative time, hospital stay, blood transfusion need, and stone clearance on follow-up ultrasound. Results: The mean age was 5.2 years. Thirty two (61%) were male, with a male-to-female ratio of 1.6:1. Average hospital stay was 48 hours, and mean operative time was 42 minutes. Stone clearance was complete in 69.23% of cases, with 36.76% having >85% clearance. Blood transfusions were needed in 19.23%, with no pleural effusions or chest tube placements. Conclusion: Mini PCNL is safe and effective for well-selected pediatric patients. Additional comparative studies are recommended for further validation.
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