MINI-PERCUTANEOUS (mini PERC) NEPHROLITHOTRIPSY IN CHILDREN

Recommendations of the European Association of Urologists, percutaneous nephrolithotomy (miniPERC) is recommended as the main treatment option for large kidney stones (> 20 mm), as well as stones > 10 mm in the lower pole of the kidney. Miniaturization of instruments, especially smaller nephroscopes, and the possibility of using lasers reduce morbidity and improve. Purpose: the present study was aimed at assessing the safety and effectiveness of miniPERC in preschool children. Material and methods. In the Department of urology of AkfaMedLine in Tashkent, from 2019 to May 2022, nephrolithotripsy using miniPERC method was performed in 43 patients aged 1 to 7 years. All procedures were performed with a Karl Storz MIP system, 12-14CH nephroscope with a 16F metal tube. Stone fragmentation was used with a holmium laser. All cases were completed by ureteral stenting without placing a nephrostomy. Results. In all cases, access to the calyx performed by ultrasound and C-arm guiding. In most cases, access was through the lower-posterior calyx (26 cases, 60.4%). In other cases, access to the kidney was performed from middle calyx and only in 3 (6.9%) through the apical posterior calyx. In 28 (65.6%) cases, the surgical sheath was used 14-16 CH and in the remaining 15 and 12 CH. In 38 (88.4%) cases, kidney stones were removed through one access, remaining 5 (11.6%) patients, using additional access to the kidney. In 35 cases, the surgery was completed with a complete cleaning of the pelvis from stones. In 8 cases with residual stones. In these cases, the next surgery was performed after 1 month. Conclusion: mini-PERC is a safe and effective technique in children that reduces hospital stay and possible complications.