The University of Southampton
University of Southampton Institutional Repository

Role of minimally invasive percutaneous nephrolithotomy techniques-micro and ultra-mini PCNL (<15F) in the pediatric population: A Systematic Review

Role of minimally invasive percutaneous nephrolithotomy techniques-micro and ultra-mini PCNL (<15F) in the pediatric population: A Systematic Review
Role of minimally invasive percutaneous nephrolithotomy techniques-micro and ultra-mini PCNL (<15F) in the pediatric population: A Systematic Review

INTRODUCTION: Management of pediatric stone disease is challenging, with standard percutaneous nephrolithotomy (PCNL) having a good stone-free rate (SFR), but with associated high complication rates. Miniaturization of this technique has led to the rise of minimally invasive PCNL techniques such as micro (<10F) and ultra-mini (<15F) PCNL procedures. Our objective was to perform a systematic review of the literature to evaluate the success and complication rates of minimally invasive PCNL techniques in the pediatric age group (<18 years).

METHODS: A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS: A total of 14 studies (456 patients), including 8 on micro-PCNL (m-PCNL, n = 233) and 6 on ultra-mini PCNL (UMP, n = 223), were included. Mean stone size ranged from 12-16.5 mm (m-PCNL) and 12-41 mm (UMP), and the overall SFR ranged from 80% to 100% (m-PCNL) and 85% to 100% (UMP). The overall complication rates for all studies were 11.2%, which was slightly higher for UMP (13.9%). Postoperative renal colic or fragment obstruction was only seen in m-PCNL, but there was a statistically significant rate of extravasation or renal pelvicaliceal perforation and hematuria for UMP compared with m-PCNL.

CONCLUSION: Miniaturized PCNL techniques can deliver high SFRs with a small risk of Clavien I/II complications. The size of tract seems to influence the nature of complications, with higher hematuria and renal extravasation with increasing tract size.

Journal Article
0892-7790
816-824
Jones, Patrick
d27beb5b-0e09-4ed5-89f0-6c62421c2397
Bennett, Grace
7504291a-ec3f-499f-84dc-838864b24233
Aboumarzouk, Omar M.
3c7e2433-638d-4378-9931-902fdc68acce
Griffin, Stephen
49c409b7-ee50-4809-b6b8-d5e192ff7424
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Jones, Patrick
d27beb5b-0e09-4ed5-89f0-6c62421c2397
Bennett, Grace
7504291a-ec3f-499f-84dc-838864b24233
Aboumarzouk, Omar M.
3c7e2433-638d-4378-9931-902fdc68acce
Griffin, Stephen
49c409b7-ee50-4809-b6b8-d5e192ff7424
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Jones, Patrick, Bennett, Grace, Aboumarzouk, Omar M., Griffin, Stephen and Somani, Bhaskar K. (2017) Role of minimally invasive percutaneous nephrolithotomy techniques-micro and ultra-mini PCNL (<15F) in the pediatric population: A Systematic Review. Journal of Endourology, 31 (9), 816-824. (doi:10.1089/end.2017.0136).

Record type: Article

Abstract

INTRODUCTION: Management of pediatric stone disease is challenging, with standard percutaneous nephrolithotomy (PCNL) having a good stone-free rate (SFR), but with associated high complication rates. Miniaturization of this technique has led to the rise of minimally invasive PCNL techniques such as micro (<10F) and ultra-mini (<15F) PCNL procedures. Our objective was to perform a systematic review of the literature to evaluate the success and complication rates of minimally invasive PCNL techniques in the pediatric age group (<18 years).

METHODS: A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS: A total of 14 studies (456 patients), including 8 on micro-PCNL (m-PCNL, n = 233) and 6 on ultra-mini PCNL (UMP, n = 223), were included. Mean stone size ranged from 12-16.5 mm (m-PCNL) and 12-41 mm (UMP), and the overall SFR ranged from 80% to 100% (m-PCNL) and 85% to 100% (UMP). The overall complication rates for all studies were 11.2%, which was slightly higher for UMP (13.9%). Postoperative renal colic or fragment obstruction was only seen in m-PCNL, but there was a statistically significant rate of extravasation or renal pelvicaliceal perforation and hematuria for UMP compared with m-PCNL.

CONCLUSION: Miniaturized PCNL techniques can deliver high SFRs with a small risk of Clavien I/II complications. The size of tract seems to influence the nature of complications, with higher hematuria and renal extravasation with increasing tract size.

Full text not available from this repository.

More information

e-pub ahead of print date: 13 June 2017
Published date: September 2017
Keywords: Journal Article

Identifiers

Local EPrints ID: 419389
URI: http://eprints.soton.ac.uk/id/eprint/419389
ISSN: 0892-7790
PURE UUID: 59bd4a8f-5399-41f5-8b2d-9b1c5992d437

Catalogue record

Date deposited: 11 Apr 2018 16:30
Last modified: 20 Mar 2020 17:31

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×