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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

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Tubeless percutaneous nephrolithotomy in children.

H Khairy Salem¹, H A Morsi, A Omran

¹Department of Pediatric Urology, Cairo University Specialized Pediatric Hospital, Urosurgery, Kasr el Einy Hospital, PO Box 247, Giza, Cairo 12515, Egypt. dr_hosni@yahoo.com

Journal of Pediatric Urology

|October 25, 2008

Summary

Tubeless percutaneous nephrolithotomy (PCNL) offers a less painful and shorter hospital stay for pediatric urolithiasis management compared to traditional PCNL. Surgeon experience influences the decision for this effective, tubeless approach.

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Area of Science:

Pediatric Urology
Minimally Invasive Surgery
Nephrolithiasis Management

Background:

Urolithiasis is a common condition in children.
Percutaneous nephrolithotomy (PCNL) is an established treatment.
The use of a nephrostomy tube in PCNL can lead to complications and discomfort.

Purpose of the Study:

To evaluate the efficacy of tubeless percutaneous nephrolithotomy (PCNL) versus traditional PCNL with a tube.
To compare outcomes in pediatric patients undergoing PCNL for urolithiasis.

Main Methods:

A comparative study of 20 children undergoing tubeless PCNL and 10 children with PCNL tube.
Follow-up included imaging for stone clearance and pain assessment.
Key outcomes measured were operative time, bleeding, need for analgesia, hospital stay, and complications.

Main Results:

Tubeless PCNL resulted in lower pain scores (mean 4.6 vs 5.5) and shorter hospital stays (median 1.7 vs 2.8 days).
No significant bleeding or major perioperative complications were observed in the tubeless group.
Urine leakage was less frequent in the tubeless group (1 vs 5 patients).

Conclusions:

Tubeless PCNL is a less painful and less burdensome option for pediatric urolithiasis.
This approach can significantly reduce hospital stay duration in children.
Intraoperative decision-making based on surgeon experience is crucial for optimal outcomes.