Semi-closed-circuit vacuum-assisted MiniPCNL system in pediatric patients. Issue 2 (April 2021)

• Record Type: Journal Article
• Authors: Berrettini, Alfredo; Sampogna, Gianluca; Zanetti, Stefano Paolo; Gallioli, Andrea; Gnech, Michele; De Marco, Erika Adalgisa; Minoli, Dario Guido; Longo, Fabrizio; Manzoni, Gianantonio; Montanari, Emanuele
• Is Part Of: Journal of pediatric urology. Volume 17:Issue 2(2021)
• Page Start: 275
• Page End: 276
• Publication Date: 2021-04
• Subjects: Pediatric urolithiasis -- Percutaneous nephrolithotomy -- Pediatric kidney stone; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2021.02.003
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Surgical treatment of kidney stones has changed over the years. The use of Mini Percutaneous Nephrolithotomy (MiniPCNL) instrumentation is associated with a reduction of major complications but it lengthens the operative time (OT). This limit may be overcome by a semi-closed-circuit vacuum-assisted MiniPCNL system, characterized by a continuous inflow and a suction-controlled outflow. We present our initial experience in pediatric patients who underwent PCNL using a 12 Fr nephroscope and a 16-Fr-large nephrostomy sheath, equipped with a lateral arm connected to suction. We used Holmium laser lithotripsy and performed lapaxy by drawing back slowly the nephroscope inside the sheath until the opening of the lateral aspiration arm, without using other devices. The stone-free rate (SFR) was assessed at 4 weeks. We included 12 procedures in 8 patients with a median age of 119 months and a median weight of 27 Kg. The median OT was 108 min and the SFR was 80%. No intra-operative complications occurred, while minor post-operative complications occurred after 4/12 procedures. These preliminary data in pediatric population showed the employed system is a safe and effective approach to treat complex kidney stones with a satisfactory SFR and a low OT.