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Minimal invasive percutaneous nephrolithotomy (Mini-PCNL) in children: Ultrasound versus fluoroscopic guidance

Ali EslahiDepartment of Urology, School of medicine, Shiraz University of Medical Sciences, Shiraz; Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, ShirazFaisal AhmedUrology research center, Al-Thora General Hospital, Department of Urology, Ibb University of Medical Since, IbbMohammad Mehdi HosseiniShiraz Nephrology-Urology Research Center, Shiraz University of Medical Sciences, ShirazMohammad Reza RezaeimehrStudent Research Committee, Shiraz University of Medical Sciences, ShirazNazanin FathiStudent Research Committee, Shiraz University of Medical Sciences, ShirazHossein‐Ali NikbakhtSocial Determinates of Health Research Center, Department of Biostatics and Epidemiology, Faculty of Medicine, Babol University of Medical Sciences, BabolMohammad Reza AskarpourDepartment of Urology, School of medicine, Shiraz University of Medical Sciences, ShirazSeyed Hossein HosseiniDepartment of Urology, School of medicine, Shiraz University of Medical Sciences, ShirazKhalil Al-naggarUrology research center, Al-Thora General Hospital, Department of Urology, Ibb University of Medical Since, Ibb

2021en

ABI

Annotatsiya

Background: Miniaturization of endoscopic instruments in percutaneous nephrolithotomy (PCNL) allowed less invasive procedures with low complication rates, especially in children. This study was conducted to evaluate the safety and efficacy of ultrasonography-guided (USG) versus fluoroscopy-guided (FG) mini-PCNL in children.Materials and methods: This is a retrospective comparative study conducted from June 2015 to June 2020. The sample included 70 children (35 pateints underwent USG mini-PCNL and 35 pateints underwent FG mini-PCNL). They were compared mainly by the patients’ demographic characteristics, procedural information, and post-treatment outcomes. In the USG mini-PCNL group, puncturing was performed using a 3.5 MHz US probe, whereas fluoroscopy was utilized in the FG mini- PCNL group. Results: Both groups were comparable in terms of gender, previous history of failed ESWL, and hydronephrosis grade. The mean stone burden was 15.94 ± 3.69 mm and 19.20 ± 7.41 mm in USG and FG groups, respectively (p = 0.024). The stonefree rate (SFR) was 97.1% in the USG group and 94.3% in the FG group, which was not statistically significant (p = 0.16). Mean operative time in the USG group and FG group was 69.00 ± 13.33 minutes and 63.48 ± 16.90 minutes, respectively. Four (11.4%) patients in the FG group required blood transfusions to restore the hemodynamic state (p = 0.039). Fever was detected in 4 (11.4%) patients in the USG group and 15 (31.4%) patients in the FG group (p = 0.041). Conclusions: In children, mini PCNL under USG is safe and as effective as fluoroscopy.

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DOI: 10.4081/aiua.2021.2.173

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