Fluoroscopy-free ultrasonography-guided percutaneous nephrolithotomy in pediatric patients: a single-center experience

• Published in: World journal of urology 2018-04, Vol.36 (4), p.667-671
• Main Authors: Nouralizadeh, Akbar, Sharifiaghdas, Farzaneh, Pakmanesh, Hamid, Basiri, Abbas, Radfar, Mohammad Hadi, Soltani, Mohammad Hossein, Nasiri, Mahmoodreza, Maleki, Esmaeil Rezghi, Lesha, Emal, Ghasemi-Rad, Mohammad, Narouie, Behzad
• Format: Article
• Language: English
• Subjects: Calcification (ectopic); Child; Child, Preschool; Children; Female; Fluoroscopy; Humans; Infant; Iran; Kidney - diagnostic imaging; Kidney - surgery; Kidney Calculi - surgery; Kidneys; Male; Medicine; Medicine & Public Health; Nephrolithotomy, Percutaneous - adverse effects; Nephrolithotomy, Percutaneous - methods; Nephrology; Oncology; Original Article; Pediatrics; Postoperative Complications; Radiation Exposure - prevention & control; Retrospective Studies; Surgery, Computer-Assisted - methods; Treatment Outcome; Ultrasonography - methods; Ultrasound; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-018-2184-z

Objectives To present the safety and efficacy of fluoroscopy-free ultrasound-guided PCNL for the treatment of renal calculi in pediatric patients of all ages. Methods 30 children with mean age of 5 years (6 months–12 years) underwent totally ultrasound-guided PCNL from March 2013 to August 2016. The pyelocalyceal system was punctured in prone position using only ultrasonography guidance, and the tract was dilated using a single shot dilation technique. No fluoroscopy was used during any of the stages of renal access. The procedure was performed using adult-sized instruments. Results The mean stone size was 27.1 ± 8.7 mm. Mean access time was 4.3 ± 2 min. Mean nephroscopic time was 34.6 ± 15.2 min. Mean hospital stay of patients was 3 days (range 2–5). 21 patients were stone-free after the procedure (70% success rate). Only four patients out of 30 experienced postoperative complications. Conclusions The results of this study showed that fluoroscopic-free ultrasound-guided PCNL in pediatric patients of all ages is safe, highly efficient, and minimizes potential radiation exposure risks associated with the procedure.