172 / 238
172
29
th
CONGRESS OF THE ESPU
S23: ENDOUROLOGY
Moderators: Anna Bujons (Spain), Rosa Romero (Spain)
ESPU Meeting on Saturday 14, April 2018, 11:06–11:44
11:06–11:11
S23-1 (LO)
★
MINI-PERC FOR RENAL CALCULI IN PEDIATRIC
PATIENTS: DOES SIZE MATTER?
M S ANSARI and Aneesh SRIVASTAV
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Pediatric Urology, Department of Urology and renal
transplantation, Lucknow, INDIA
OBJECTIVE
To assess the safety, efficacy, and stone-free rate (SFR) of Min-perc nephrolithotomy (m-PCNL)
and compare it with conventional PCNL (cPCNL) for the management of renal calculi in pediatric
patients under 18 years of age.
MATERIAL AND METHODS
50 patients with renal calculi were randomly divided into two groups in prospective manner, mPCNL:
were managed by mini-Perc (size15 Fr.) and conventional PCNL (cPCNL) (size 24 Fr.). The mean
age, sex, stone burden, operating time, complications (haematuria, drop in hematocrit), pain score
(lumbar pain), need of analgesia, perinephric extravasation, nephrostomy site leak, hospital stay,
and stone free rate (SFR) were compared between the two groups. The success of the procedure
was defined as the absence of residual stones or small residuals of 3
⩽
mm on ultrasonography or
X ray KUB at 12 weeks postoperatively.
RESULTS
Both the groups were comparable for preoperative parameters. The mean stone size was
1.9 (10.75–35.25) mm and the mean number of stones was 2 (1–5). The mean (SD) operating
time was statistically significantly longer in m-PCNL [90+ 25 min] as compared to cPCNL 70.2±20,
p=0.04]. On first session of PCNL the SFR for m-PCNL was 94.2 % and for cPCNL 93.31 %, which
was not significantly different (P = 0.060). On re-look SFR improved to 97.3 % and 96.2 % respec-
tively. Episodes of haematuria and drop in hematocrit was more in cPCNL as compared to mPCNL
[p=0.03.]. Likewise, pain score, need of analgesia, perinephric extravasation and nephrostomy site
leak was higher in cPCNL as compared to mPCNL [p=0.02]. Although the hospital stay was longer
in cPCNL as compared to mPCNL this was not statistically significant (P = 0.244).
CONCLUSIONS
Mini-Perc offers good outcomes with lower complications rates compared to the conventional tech-
nique. The size of tract influences the nature of complications such as higher haematuria, lumbar
pain and renal extravasation.