Korean J Urol.  2015 Jul;56(7):519-524. 10.4111/kju.2015.56.7.519.

Ultramini nephrostomy tract combined with flexible ureterorenoscopy for the treatment of multiple renal calculi in paediatric patients

• Guo J
• Yang WZ
• Zhang Y
• An F
• Wei R
• Li Y
• Zhang H

• KMID: 2160649
• DOI: http://doi.org/10.4111/kju.2015.56.7.519

Abstract

PURPOSE
To assess the safety and efficacy of an ultramini nephrostomy tract, which we were using for the first time, combined with flexible ureterorenoscopy (URS) in the treatment of pediatric patients with multiple renal calculi.
MATERIALS AND METHODS
Twenty pediatric patients (age, < or =6 years) underwent ultramini percutaneous nephrolithotomy (PCNL) combined with flexible URS. The group had multiple renal calculi, which were bilateral in 3 cases and were located in a total of 23 sites. The calculi were located in 2 calyces in 10 cases, scattered in more than 2 calyces in 7 cases, and limited to 1 calyx in 3 cases. The average patient age was 37.35 months (range, 14-68 months). The average stone diameter was 2.0 cm (range, 1-3.0 cm). In all patients, an ultramini nephrostomy tract was established under ultrasound guidance (dilated to F10) with simultaneous sheath placement. The flexible URS was placed into the collecting system during holmium laser lithotripsy.
RESULTS
When ultramini PCNL was combined with flexible ureterorenoscopic holmium laser lithotripsy, the complete stone-free rate was 87% (20/23). The average level of hemoglobin decreased to 1.0 g/dL after the operation. No blood transfusions were needed. Levels of blood urea nitrogen, creatinine, and C-reactive protein were not significantly different before and after the operation. The average duration of hospitalization was approximately 4.85 days, and all cases were followed up for 6 to 12 months. No complications were found.
CONCLUSIONS
Ultramini PCNL combined with flexible ureterorenoscopic holmium laser lithotripsy is a safe and effective treatment for children with multiple renal calculi.

Keyword

Kidney calculi; Lithotripsy; Pediatrics; Percutaneous nephrolithotomy; Ureteroscopy

MeSH Terms

Adolescent
Adult
Aged
Female
Humans
Kidney Calculi/pathology/*surgery/ultrastructure
Length of Stay/statistics & numerical data
Lithotripsy, Laser/methods
Male
Middle Aged
Nephrostomy, Percutaneous/*methods
Retrospective Studies
Treatment Outcome
Ultrasonography, Interventional/methods
Ureteroscopy/*methods
Young Adult

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