Is Mini Percutaneous Nephrolithotomy a Game Changer for the Treatment of Renal Stones in Children?

Mahmood, Sarwar Noori; Falah, Barzy; Ahmed, Choman J.; Fakhralddin, Saman Salih; Tawfeeq, Hewa

doi:10.1016/j.euros.2021.12.014

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…In a following study comparing the efficacy and the safety of ultrasonography-guided vs. fluoroscopy-guided “mini-PCNL” in children, Eslahi et al ( 12 ) reported higher stone-free rates: 97.1% in the ultrasonography-guided group ( n = 35 patients) and 94.3% in the fluoroscopy-guided group ( n = 35 patients). Similar results were published more recently: Mahmood ( 13 ) in 143 patients experienced a 92.4% of stone-free rate after a single “mini-PCNL” session independently by patient's age.…”

Section: Miniaturized Technologiessupporting

confidence: 86%

Pediatric Urolithiasis: Current Surgical Strategies and Future Perspectives

et al. 2022

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New technological innovations and cutting-edge techniques have led to important changes in the surgical management of pediatric urolithiasis. Miniaturized technologies and minimally invasive approaches have been increasingly used in children with urinary stones to minimize surgical complications and improve patient outcomes. Moreover, the new computer technologies of the digital era have been opening new horizons for the preoperative planning and surgical treatment of children with urinary calculi. Three-dimensional modeling reconstructions, virtual, augmented, and mixed reality are rapidly approaching the surgical practice, equipping surgeons with powerful instruments to enhance the real-time intraoperative visualization of normal and pathological structures. The broad range of possibilities offered by these technological innovations in the adult population finds increasing applications in pediatrics, offering a more detailed visualization of small anatomical structures. This review illustrates the most promising techniques and devices to enhance the surgical treatment of pediatric urolithiasis in children, aiming to favor an early adoption and to stimulate more research on this topic.

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Section: Miniaturized Technologiessupporting

confidence: 86%

Pediatric Urolithiasis: Current Surgical Strategies and Future Perspectives

et al. 2022

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“…Regarding this issue, in an original study focusing on the role of mini-PNL in children with large and complex staghorn stones, authors have reported an SFR of 78% along with a high rate of severe (17%) complications [18]. Outcomes of some other studies did also show SFR's and complication rates of 58% − 94% and 13% − 42%, respectively [14,15,18]. Although, some authors have suggested that the overall complication rate could be signi cantly correlated to procedure time, the number of access tracts, and stone size [39,40], we performed a single tract in the majority of our cases which certainly limited the degree of invasiveness and the stone size did not affect our success rates.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, stone-free rates after a single mini-PNL session vary between 86% and 98% in children with large stones. Even higher success rates could be obtained with the additional RIRS/SWL procedures in a combined manner [6, [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Mini Vs Standart Pnl in the Management of Complex Renal Stones in Children: is the Role of Standard Pnl Over?

Güzel¹,

Mousawi

Ozcan

et al. 2023

Preprint

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Aim To evaluate the efficacy and safety of Mini vs Standard PNL in the management of large calculi in children. Patients and Methods: A total of 64 pediatric cases with large stones underwent either mini-PNL (Group 1, n = 42) or standard PNL procedure (Group 2, n = 22) for the minimal invasive management of these calculi. Pre-intra and post operative data were analyzed in a comparative manner. Results A total of 64 children (40 boys, 24 girls) with an overall mean age 9.78 ± 4.2 months were included in this study. The overall mean burden of the stones was 168.64 ± 14.4 mm2. While a 17 Fr rigid pediatric nephroscope with a laser or pneumatic intracorporeal lithotripsy were used through 20–22 Fr sheath for mini PNL procedure, 26 Fr nephroscope with a pneumatic intracorporeal lithotripsy were used through 30 Fr sheath for standard PNL procedures. Stone-free rates were 88.1% and 86.3% in Group 1 and 2 respectively after 1 day. Mean operative time was similar in both groups and average hospitalization time was longer in cases undergoing standard-PNL. While the mean hemoglobin drop was 0.52 ± 0.1 g/dl in Group 1, this value was 1.34 ± 0.4 g/dl in standard PNL group. No major complication was observed in both groups. Conclusions Although pediatric miniaturized PNL systems are performed with safe and effective outcomes with complex stones; standard PNL may also be a rational option in selected cases where these systems and expertise are not available. Additionally number of punctures could be limited with the application of large bore tracts.

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“…Indeed, this approach is now being increasingly used by some centres as their standard PCNL approach in children. 65 Miniaturisation also increases feasibility for tubeless exit strategies, which results in reduction in pain and hospital stay. 30,66 Limitations of miniaturisation in PCNL have been issues of reduced visibility, difficulty extracting fragments and higher intrarenal pressures.…”

Section: Treatment Optionsmentioning

confidence: 99%

Paediatric kidney stone surgery: state-of-the-art review

Juliebø‐Jones

Keller

Tzelves

et al. 2023

Therapeutic Advances in Urology

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While urolithiasis in children is rare, the global incidence is rising, and the volume of minimally invasive surgeries being performed reflects this. There have been many developments in the technology, which have supported the advancement of these interventions. However, innovation of this kind has also resulted in wide-ranging practice patterns and debate regarding how they should be best implemented. This is in addition to the extra challenges faced when treating stone disease in children where the patient population often has a higher number of comorbidities and for example, the need to avoid risk such as ionising exposure is higher. The overall result is a number of challenges and controversies surrounding many facets of paediatric stone surgery such as imaging choice, follow-up and different treatment options, for example, medical expulsive therapy, shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. This article provides an overview of the current status of paediatric stone surgery and discussion on the key topics of debate.

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Is Mini Percutaneous Nephrolithotomy a Game Changer for the Treatment of Renal Stones in Children?

Cited by 8 publications

References 29 publications

Pediatric Urolithiasis: Current Surgical Strategies and Future Perspectives

Pediatric Urolithiasis: Current Surgical Strategies and Future Perspectives

Mini Vs Standart Pnl in the Management of Complex Renal Stones in Children: is the Role of Standard Pnl Over?

Paediatric kidney stone surgery: state-of-the-art review

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