Initial report of SMP in the treatment of pediatric nephrolithiasis

Liu Yongda; Aierken Tuerxun; Cai Chao; Liu Yang; Abudukahaer Batuer; Zhou Yizhou; Luo Jiawei; Wu Wenqi; Chen Wenzhong; Zhong Wen; Zeng Guohua

doi:10.3969/j.issn.2095-5146.2016.05.011

Abstract：Objective: To evaluate the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP) in the treatment of pediatric renal stones.Methods: Data of 51 pediatric patients with renal stones who were managed by SMP in the First People's Hospital of Kashi from September 2014 to September 2015 were retrospectively reviewed,including 32 boys and 19 girls.The mean age of patients was (2.9±2.4) years (range: 5 months to 12 years).The mean stone burden was (1.9±0.7) cm (range: 0.8 to 4.8 cm).Results: Of 51 cases,49 cases were managed by SMP successfully in one session,however,2 cases were given two-stage SMP due to pyonephrosis.The mean operative time was (49.8±15.5) min.The mean hemoglobin drop was found to be (10.4±4.7) g/L and no transfusion was needed.There were 44 cases (86.3%) without nephrostomy tube or ureteric stent (totally tubeless),2 cases (3.9%) only with ureteric catheter,2 cases (3.9%) with nephrostomy tube and ureteric catheter,and 3 cases (5.9%) with nephrostomy tube and double J stent.The stone-free rate (SFR) at 24 h and 3 months was 86.3% and 90.2%,respectively.Clavien Ⅰ/Ⅱ complication rate was 15.7% (8/51),including 3 cases of postoperative fever,1 case of hematuria,2 cases of minimal pelvis perforation and 2 cases of urinary extravasation.The postoperative hospital stay was (2.7±1.0) days.Conclusions: SMP is safe and effective for the management of <2.5 cm renal stones in children.SMP could be an ideal alternative modality for pediatric renal stones that not amenable to extracorporeal shock wave lithotripsy or flexible ureteroscopic lithotripsy.