Comparison of super-mini-PCNL and flexible ureteroscopy for the management of upper urinary tract calculus (1–2 cm) in children

• Published in: World journal of urology Vol. 39; no. 1; pp. 195 - 200
• Main Authors: Jia, Hongliang, Li, Jiuzhi, Liu, Bide, Zhang, Peixin, Yusufu, Ainiwaer, Nan, Yukui, Li, Xun, Wen, Bin, Pu, Chunlin, Du, Weili, Wang, Shuheng
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2021; Springer Nature B.V
• Subjects: Calculi; Children; Medicine; Medicine & Public Health; Nephrology; Oncology; Original Article; Patients; Radiography; Surgery; Urinary tract; Urogenital system; Urology; Super-mini percutaneous nephrolithotomy (SMP); Retrograde intrarenal surgery (RIRS); Upper urinary tract calculus; Child
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-020-03150-x

Objectives
To retrospectively evaluate the efficacy and safety of super-mini percutaneous nephrolithotomy (SMP) and retrograde intrarenal surgery (RIRS) for children with upper urinary tract calculus (1–2 cm).
Patients and methods
Children with upper urinary tract calculus (1–2 cm) who underwent the SMP or RIRS were enrolled in this study. Patients were divided into two groups: group SMP, 36 patients; and group RIRS, 25 patients. Patients were evaluated with KUB radiography or CT after 1 month. The collected data were analyzed.
Results
The mean stone size was 14.18 mm in group SMP, and 14.00 mm in group RIRS (
p
 = 0.812). Group RIRS compared to group SMP showed longer operating time [76.3 vs 53.9 min (
p
 = 0.002)], and postoperative hospital stay [4.2 vs 2.9 days (
p
 = 0.011)]. The overall stone-free rate (SFR) was 94.4% for group SMP, and 60.0% for group RIRS in 1 month after operation (
p
 = 0.001). The re-treatment rate was significantly higher in group RIRS compared to group SMP [20.0% vs 0.0% (
p
 = 0.009)]. The complication rate was 5.6%, and 24.0% for groups SMP, and RIRS, respectively (
p
 = 0.036).
Conclusions
SMP was more effective than RIRS to obtain a better SFR, less re-treatment rate, and complication rate in children with upper urinary tract calculus (1–2 cm).