WCE 2019: Mini Versus Standard Percutaneous Nephrolithotomy For Treatment 0f Pediatric Renal Stones: Is Smaller Enough?

Abu Dhabi, United Arab Emirates (UroToday.com) Dr. SarwarMahmood and his colleagues retrospectively assessed the safety and efficacy of renal stones treated by miniature percutaneous nephrolithotomy (mPCNL) in 134 pediatric patients below the age of 17 years-old at a single tertiary care center.

Dr. Mahmood defined mPCNL as any procedure that uses a 20Fr access sheath with a 12 Fr nephroscope. Standard PCNL was defined as a procedure that uses a 22 to 26 Fr access sheath coupled with an 18 Fr nephroscope. His primary endpoint of interest was stone free rate, defined as any leftover fragments seen on ultrasound or abdominal x-ray postoperatively. Overall, stone free rate in mPCNL was 89.5% and in standard PCNL was 94.7%, though this difference was not statistically different. Dr. Mahmood also noted that patients who underwent mPCNL had statistically significant shorter lengths of stay and were less likely to have hemoglobin drops postoperatively. Overall complication rates were equivalent between mPCNL and standard PCNL patients. 

In conclusion, Dr. Mahmood and his colleagues found that mPCNL is a valuable and safe way to treat simple and complex stones in pediatric patients, with outcomes comparable to that of standard PCNL. Furthermore, pediatrics patients may benefit from mPCNL postoperatively, as they had shorter lengths of stay and fewer hemoglobin drops. 


Presented by: Sarwar Noori Mahmood, MD, FIBMS, FEBU, Assistant Professor of Urology, Department of Surgery, College of Medicine, University of Sulaimania

Written by: Lillian Xie, BA, Department of Urology, University of California, Irvine, California at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates