Clinical application of super-mini PCNL (SMP) in the treatment of upper urinary tract stones under ultrasound guidance

To present the safety and efficacy of totally ultrasonography-guided Super-mini percutaneous nephrolithotomy (SMP) in the treatment of upper urinary tract stones both in children and adults.

We carried out SMP in 104 patients (including 48 children and 56 adults) with upper urinary tract stones between June 2015 and February 2017. All steps of renal access were performed by ultrasonography. The lithotripsy was performed using either Holmium laser or pneumatic lithotripter. Perioperative and postoperative parameters along with operative data were recorded in detail.

The mean age of children and adult patients were 4.4 ± 3.6 and 44.3 ± 15.7 years old, respectively. The stone burden was comparable for both groups (1.72 ± 0.66 vs 1.74 ± 0.56 cm, p = 0.852). Mean operation time was not significant different between two groups (p = 0.052), while the mean haemoglobin drop in children was much lower in adult patients (6.3 ± 6.9 vs 10.9 ± 8.69, p = 0.004). Both groups had similar SFRs in postoperative 1 day and at 1-month follow-up (p = 1.000, p = 0.912). Mean hospital stay of children and adult patients was 2.3 ± 0.8 and 2.2 ± 0.76 days (p = 0.484). The total complication rate was significantly lower in two groups (p = 1.000); none of the patients required blood transfusion.

Ultrasonography-guided SMP was a safe and effective treatment option for moderate-sized upper urinary tract stones, and has the advantage of preventing radiation hazard, especially for pediatric stone patients.

World journal of urology. 2018 Aug 30 [Epub ahead of print]

Abulizi Simayi, Yang Liu, Muyesaier Yiming, Jad AlSmadi, Ainiwaer Yusufu, Yalikun Alimu, Peng Lei, Xiaoan Zhang, Bin Wen, Guohua Zeng, Wenqi Wu

Department of Urology, The Xinjiang Uyghur Autonomous Region People's Hospital, Urumqi, Xingjiang, China., Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, China., Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, China. .