Mini Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Pediatric Renal Stones (10-30 mm)

Tanta University90 enrolled

Overview

This work aimed to compare the safety and efficacy of retrograde intrarenal surgery using single-use flexible ureteroscopy (FURS) with mini-percutaneous nephrolithotomy (PCNL) in children with renal stones measuring 10-30 mm.

Children have a smaller pelvicalyceal system, more delicate tissues, and a more curved ureter compared to adults. While percutaneous nephrolithotomy (PCNL) offers excellent stone-free rates for large stones (\>2 cm), its application in children presents challenges due to their smaller renal anatomy and increased kidney mobility. Retrograde intrarenal surgery with flexible ureteroscopy (FURS) major advantage lies in utilizing natural orifices, eliminating the need for additional access routes with theoretically enhanced faster postoperative recovery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Mini Percutaneous Nephrolithotomy Retrograde Intrarenal Surgery Pediatric Renal Stones

Interventions

Mini percutaneous nephrolithotomyPROCEDURE

Patients underwent mini percutaneous nephrolithotomy (PCNL) technique.

Flexible ureteroscopyPROCEDURE

Patients underwent single use flexible ureteroscopy (FURS).

Eligibility

Sex: ALLMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Children \<18 years old. * Both sexes. * Single calyceal renal stone of 10-20 mm in maximum diameter, single renal pelvic stone of 10-20 in maximum diameter with history of failed, extracorporeal shock wave lithotripsy (ESWL) or refused ESWL, single renal stone 20-30 mm in maximum diameter and multiple renal stones with total stone size 10-30 mm (sum of maximum dimensions of each stone). Exclusion Criteria: * Patients with uncorrected coagulopathy. * Renal or ureteral malformation. * Cases with significant anatomical obstruction requiring separate intervention or associated metabolic disorder.

Locations (1)

Tanta University

Tanta, El-Gharbia, Egypt

Outcomes

Primary Outcomes

Incidence of complications

Incidence of complications will be recorded according to the Clavien-Dindo grading system. The Grades of the Clavien-Dindo Classification: * Grade I: Any deviation from the normal postoperative course. It does not need pharmacological treatment or surgical, endoscopic, and radiological interventions. * Grade II: Requires pharmacological treatment with drugs other than those allowed for Grade I. Blood transfusions and total parenteral nutrition. * Grade III: Requires surgical, endoscopic, or radiological intervention. Grade IIIa: Intervention done without general anesthesia. Grade IIIb: Intervention done under general anesthesia. * Grade IV: Life-threatening complication requiring intermediate or intensive care unit management. Grade IVa: Single-organ dysfunction. Grade IVb: Multi-organ failure. * Grade V: Death of the patient.

Time frame: 24 hours postoperatively

Secondary Outcomes

Operative time

Operative time will be recorded from start till the end of surgery.

Time frame: Up to 3 hours

Fluoroscopy time

Total duration of fluoroscopy exposure during the procedure will be measured in seconds, from the first fluoroscopic image until the final image

Time frame: Intraoperatively

Postoperative stenting

Percentage of participants requiring ureteral stent placement after the procedure will be recorded.

Time frame: Immediately after the procedure (Up to 2 hours)

Lenght of hospital stay

Lenght of hospital stay will be recorded from the admission till the discharge from the hospital.

Time frame: Till the discharge from hospital (Up to 2 weeks)

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.