metricas
covid
Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Micropercutaneous nephrolithotomy. A new therapeutic option for pediatric renal ...
Journal Information
Vol. 38. Issue 7.
Pages 483-487 (September 2014)
Share
Share
Download PDF
More article options
Visits
420
Vol. 38. Issue 7.
Pages 483-487 (September 2014)
Skill and talent
Micropercutaneous nephrolithotomy. A new therapeutic option for pediatric renal lithiasis
Nefrolitotomía micropercutánea: una nueva opción terapéutica para la litiasis renal pediátrica
Visits
420
D. Pérez-Fentes
Corresponding author
, B. Blanco-Gómez, C. García-Freire
Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (1)
Table 1. Main results of the micropercutaneous nephrolitotomy series.
Abstract
Introduction

Micropercutaneous nephrolithotomy is an evolution from the conventional percutaneous surgery in which pyelocaliceal access is obtained through minimum bore holes. Its objective is the complete removal of the calculi, lowering the morbidity associated with larger bore percutaneous tracts.

Materials and methods

We present the case of a micropercutaneous nephrolithotomy performed in a 14-year-old female patient with a 35mm diameter kidney stone located in the renal pelvis. Surgery was performed in the Galdakao-modified supine Valdivia position. Puncture was done under ultrasound and fluoroscopic guidance. The 4.85Ch needle of the Microperc® set was used, completing the procedure through the 8Ch working shaft. Lasertripsy was done with the Ho:YAG laser. An indwelling double J stent was placed at the end of the procedure.

Results

Operating time was 170min. Hospital stay was one day. She suffered renal colic after 72h, which was resolved with oral analgesic treatment at home (Clavien I). She returned to school on the fifth postoperative day. The double J was removed at two weeks. At one month of the surgery, the patient is asymptomatic, a 4mm lower calyx residual stone being observed in the abdominal ultrasound.

Conclusion

Micropercutaneous nephrolithotomy is a step forward toward the search for a less invasive kidney stone treatment. It is a safe and effective technique in the pediatric population, and it can be performed in the supine position, even in orthotropic kidneys. Future studies and collaborative works will help to better define its indications, to optimize its technique and to analyze its cost-effectiveness compared with other treatment options.

Keywords:
Percutaneous nephrolithotomy
Urinary calculi
Pediatrics
Surgical technique
Resumen
Introducción

La nefrolitotomía micropercutánea es una evolución de la cirugía percutánea convencional en la que se accede al sistema pielocalicial mediante orificios de mínimo calibre. Su objetivo es la completa eliminación del cálculo, disminuyendo la morbilidad producida por la realización de trayectos percutáneos de mayor diámetro.

Material y métodos

Presentamos la realización de una nefrolitotomía micropercutánea en una paciente de 14 años con litiasis renal de 35mm de diámetro situada en la pelvis renal. La cirugía se realiza en posición supina de Valdivia modificada en Galdakao. Punción guiada por ultrasonidos y fluoroscopia. Se emplea la aguja 4,85 Charrière (Ch) del set de Microperc®, completando el procedimiento a través de la vaina 8Ch. Lasertricia con láser Ho:YAG. Se deja catéter doble J al finalizar el procedimiento.

Resultados

Tiempo quirúrgico de 170min. Estancia hospitalaria de un día. Cólico renal a las 72h resuelto con analgesia en domicilio (Clavien I). Reincorporación a la vida escolar al 5.° día. Retirada del catéter doble J a las 2 semanas. La paciente está asintomática al mes de la intervención, observándose en la ecografía abdominal un resto de 4mm en el cáliz inferior.

Conclusión

La nefrolitotomía micropercutánea es un nuevo paso adelante hacia la búsqueda de la menor invasividad en el tratamiento de la litiasis renal, siendo una técnica segura y efectiva en la población pediátrica, pudiendo ser realizada en decúbito supino en riñones ortotópicos. Futuros estudios y trabajos colaborativos ayudarán definir mejor sus indicaciones, a optimizar su técnica quirúrgica y a analizar su coste-efectividad comparada con otros tratamientos.

Palabras clave:
Nefrolitotomía percutánea
Cálculos urinarios
Pediatría
Técnica quirúrgica

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos