Supine minitubeless percutaneous nephrolithotomy for the management of renal stones in paediatric population: A prospective single-centre experience.

Abstract

Objectives: To assess the feasibility, safety, and efficacy of supine minitubeless percutaneous nephrolithotomy (PCNL) for managing renal stones in paediatric patients.

Patients and methods: A prospective, observational, single-surgeon study was conducted at Ford Hospital and Research Centre over 2 years, including paediatric patients (<14 years) presenting with renal stones. Patient demographics, stone characteristics, intraoperative parameters, postoperative outcomes, stone-free rates (SFRs), complications, and hospital stay were recorded. Statistical analysis was performed using XLSTAT 2021. Double-J stents were placed in all cases without a nephrostomy tube. SFR was defined as complete clearance or residual fragments <2 mm in the computed tomography scan. The Clavien-Dindo system was used for grading the complications.

Results: Fifty paediatric patients were analyzed. The mean age was 6.45 years. Mean stone size was 15.24 mm, with a mean Hounsfield Unit of 829.54 ± 161.94. Mean operative time was 38.38 min. Stone-free status was achieved in 96% of patients at 3 months, with two patients requiring retrograde intrarenal surgery for residual stones. The mean haemoglobin drop was 0.51 g/dL and the mean hospital stay was 1.4 days. Minor Clavien-Dindo Grade I/II complications occurred in 12% of cases (fever 4%, pain 6%, and mild ascites 2%), all resolving spontaneously. No major complications or blood transfusions occurred.

Conclusion: Supine mini-tubeless PCNL appears to be a safe and effective surgical management of paediatric renal stones, offering high SFRs with minimal complications, and short hospital stays. This technique may represent a useful minimally invasive treatment option, particularly when flexible ureteroscopy is limited.