Open AccessMinimal invasive percutaneous nephrolithotomy (Mini-PCNL) in children: Ultrasound versus fluoroscopic guidance
Author(s) -
Ali Eslahi,
Faisal Ahmed,
Mohammad Mehdi Hosseini,
Mohammad Reza Rezaeimehr,
Nazanin Fathi,
HosseinAli Nikbakht,
Mohammad Reza Askarpour,
Seyed Hossein Hosseini,
Khalil Al-naggar
Publication year - 2021
Publication title -
archivio italiano di urologia andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.429
H-Index - 23
eISSN - 2282-4197
pISSN - 1124-3562
DOI - 10.4081/aiua.2021.2.173
Subject(s) - medicine , percutaneous nephrolithotomy , fluoroscopy , surgery , percutaneous , ultrasonography , ultrasound , retrospective cohort study , postoperative fever , radiology
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.