173 / 238
173
11–14 APRIL, 2018, HELSINKI, FINLAND
11:11–11:14
S23-2 (PP)
FLANK-FREE MODIFIED SUPINE PERCUTANEOUS
NEPHROLITHOTOMY IN PEDIATRIC AGE GROUP
Ehab ELSAYED
1
, Esam DESOUKY
1
, Ahmed ELIWA
2
, Mohamed SLEEM
2
, Waleed
SHABANA
2
, Tamer DAWOOD
2
, Mohamed TELB
2
and Salem KHALIL
3
1) Zagazig university hospital, Urology, Zagazig, EGYPT - 2) Zagazig university hospital, Zagazig, EGYPT - 3) Zagazig
university hospital, Zagazig, EGYPT
PURPOSE
To evaluate the safety and efficacy of pediatric percutaneous nephrolithotomy (PCNL) in the flank-
free modified supine position (FFMSP). PCNL in the supine position is increasingly and success-
fully used in pediatric age group. Different modifications of supine positions have been described;
however, the best supine position is not well established and remains a matter of debate.
MATERIAL AND METHODS
This prospective study included 22 children presenting with single renal pelvis stone (2–3 cm)
in the period between May 2012 and April 2014. Diagnosis was set by plain x-ray and computed
tomography in all patients. PCNL was performed with the patients placed in the FFMSP. The opera-
tive time and hospital stay were estimated. The outcome and any perioperative complica- tions or
conflicts were recorded.
RESULTS
The study included 22 children (15 boys and 7 girls) with a solitary renal pelvis stone. Mean '
standard deviation age of the patients was 9.5 ' 3.2 years (range, 3–15.5 years). Stone length,
operative time, and hospital stay had mean ' standard deviation of 2.4 ' 0.23 cm, 65.1 ' 18.7 minutes,
and 4.4 ' 0.9 days. Stone-free rate was 90.9 % after 1 session of PCNL. One patient (4.5 %) needed
a second-look PCNL. Shock wave lithotripsy was performed for another patient. Postoperative fever
occurred in 4 patients (18.2 %). One patient received postoperative blood transfusion. Postoperative
transient urinoma occurred in 2 patients (9.1 %).
CONCLUSIONS
PCNL in pediatric age group via FFMSP was proved to be safe and effective in management of
renal pelvis stones of size 2–3 cm. It provides stone clearance rate comparable with that re- ported
of conventional PCNL in the prone position.
11:14–11:17
S23-3 (PP)
COMBINED URETEROSCOPY AND PCNL IN CHILDREN
Vishal KADELI
1
, R. B. NERLI
1
, Shridhar GHAGANE
2
, Shankar K
1
and Neeraj DIXIT
2
1) KLE University's JN Medical College, KLES Kidney Foundation, KLES Dr. Prabhak, Department of Urology, Belagavi,
INDIA - 2) KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & MRC, Department of Urology, Belagavi, INDIA
PURPOSE
Urinary tract stones represents an emerging problem in children. Introduction of smaller endo-
scopes, lasers and improved technology has offered a new dimension. Supine positioning has
certainly contributed to the new life of PCNL and offers combined percutaneous and retrograde
approach during the same surgical procedure. In this prospective study we have used the GMSV
position to simultaneously treat ureteric and ipsilateral renal stones by retrograde ureteroscopy and
supine PCNL in children.