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Outcomes of miniaturized percutaneous nephrolitotomy in infants: single centre experience

Eyyup Sabri Pelit1, Bülent Kati1, Cengiz Çanakci2

  • 1Department of Urology, Harran University Faculty of Medicine, Sanliurfa, Turkey.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|July 21, 2017
PubMed

Insights

Mini-percutaneous nephrolithotomy (Mini-PNL) is a safe and effective treatment for kidney stones in infants under 3 years old. This procedure offers a high stone-free rate with minimal complications, making it a viable option for pediatric urolithiasis.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Management

Background:

  • Kidney stones (renal lithiasis) in infants (<3 years) present unique management challenges.
  • Limited data exists on the efficacy and safety of minimally invasive techniques in this age group.
  • Percutaneous nephrolithotomy (PNL) has been adapted for pediatric use, with Mini-PNL emerging as a potentially less invasive option.

Purpose of the Study:

  • To evaluate the safety and efficacy of Mini-PNL for treating kidney stones in infants aged less than 3 years.
  • To report outcomes from one of the largest series of Mini-PNL in this specific pediatric population.
  • To assess the stone-free rate, operative time, complications, and hospitalization duration associated with Mini-PNL in infants.

Main Methods:

  • Retrospective review of medical records for 74 infant patients who underwent Mini-PNL for renal stones (May 2012 - April 2016).
  • Pre-operative evaluation included radiography, ultrasound, CT, and/or IVU.
  • Analysis of pre-operative, intra-operative, and post-operative data, including stone size, operative time, and complications.

Main Results:

  • 74 infants (mean age 21.5 months) with mean stone size of 22.0 mm were treated.
  • A 17 Fr rigid pediatric nephroscope and pneumatic lithotripsy were utilized.
  • The stone-free rate was 84.7% at 1 month post-operation.
  • Mean operative time was 74 minutes, with a mean fluoroscopy time of 4.3 minutes.
  • No major complications (Clavien IV-V) were observed; 15.3% required auxiliary procedures.

Conclusions:

  • Mini-PNL, utilizing pneumatic intracorporeal lithotripsy, is a safe and effective treatment modality for pediatric kidney stones in infants.
  • The procedure demonstrates a high stone-free rate and a low incidence of significant complications in this young patient cohort.
  • Mini-PNL represents a valuable minimally invasive surgical option for managing urolithiasis in infants.
Abstract

Keywords:
InfantKidney CalculiNephrostomy, Percutaneous

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