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Sources of Funding: None

Introduction

The modified supine Percutaneous Nephrolithotomy (PCNL) is an attractive alternative option to the prone PCNL for the management of large (>2cm) intra-renal calculi. This technique has shorter operative times, similar complication rates and length of hospital stays to the prone position. There are only two studies in the pediatric population. This study aims to evaluate the safety and efficacy of the supine PCNL in the pediatric population.

Methods

This is a single-center, prospective study, conducted at Monash Health, Australia. It includes patients under the age of 18 years who underwent a supine PCNL between April 2007 and June 2015. The Monash Health Human Research Ethics Committee approved this as a Quality and Service improvement activity. Data was collated on patient age, number, size and composition of stones, technique used, equipment used, length of surgery and complications.

Results

Thirteen patients (3 girls and 10 boys) with a mean age of 8.2 years were included. Of these, 12 had at least one renal calculus with the largest calculi having a mean size of 15mm and the procedure took 114 minutes. The stone clearance rate was 69%, three patients had residual stones on follow-up imaging. The mean length of stay was 3 days. One patient required ICU post-operatively for sepsis and two patients required blood transfusions. These results are comparable to prone PCNL.

Conclusions

The Modified supine PCNL is a safe and effective and method of retrieving large calculi in the pediatric population and is comparable to the prone PCNL.

Funding

None