Mini-percutaneous nephrolithotomy for pediatric complex renal calculus disease: one-stage or two-stage?

• Published in: International urology and nephrology 2019-02, Vol.51 (2), p.201-206
• Main Authors: Fan, Ben-Yi, Gu, Lan, Chand, Harripersaud, Liu, Wen-Jun, Yuan, Jun-Bin
• Format: Article
• Language: English
• Subjects: Adolescent; Blood Loss, Surgical - prevention & control; Blood Loss, Surgical - statistics & numerical data; Calcification (ectopic); Calculi; Child; Children; China - epidemiology; Comparative Effectiveness Research; Creatinine; Female; Humans; Inflammation; Kidney Calculi - diagnosis; Kidney Calculi - physiopathology; Kidney Calculi - surgery; Length of Stay - statistics & numerical data; Lithiasis; Male; Medicine; Medicine & Public Health; Nephrolithotomy, Percutaneous - adverse effects; Nephrolithotomy, Percutaneous - methods; Nephrology; Operative Time; Outcome and Process Assessment (Health Care); Pediatrics; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Sepsis; Systemic inflammatory response syndrome; Systemic Inflammatory Response Syndrome - diagnosis; Systemic Inflammatory Response Syndrome - epidemiology; Systemic Inflammatory Response Syndrome - etiology; Ultrasonography, Interventional - methods; Ultrasound; Urology; Urology - Original Paper
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-018-2054-z

Objectives To compare two different treatment strategies, one-stage and two-stage multi-tract mini-percutaneous nephrolithotomy (mt-mPCNL), for pediatric complex renal calculus disease. Methods Between the period of July 2016 and July 2018, a total of 36 children aged 15 years and younger, with complex renal calculi disease, who underwent total ultrasound-guided mt-mPCNL by a single experienced urologist were enrolled in our study. All patients were assigned either to Group 1 ( n  = 18) who received one-stage mt-mPCNL or Group 2 ( n  = 18) who received planned two-stage mt-mPCNL. Results The demographic data were comparable between the two groups. There were no serious complications (Modified Clavien Grade ≥ III) observed in either group. The stone -free rate (SFR), operation time, postoperative creatinine increase, and perioperative complication rates were similar in both groups ( P  = 0.603, 0.818, 0.161, and 0.402, respectively). The postoperative hospital stay (5.8 days vs. 7.4 days) and cost (17373.3 CNY vs. 23717.1 CNY) were statistically less in Group 1. Group 2 had significantly less total estimated blood loss (70.6 ml vs. 130.0 ml, P