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Comparison between mini-Percutaneous Nephrolithotomy (PCNL) and standard PCNL in pediatric patients: a systematic review and meta-analysis

  • Kindy Aulia ,
  • Widi Atmoko ,
  • Ponco Birowo ,
  • Nur Rasyid ,


Abstract

Background: We conducted a systematic review and meta-analysis to determine the efficacy and safety of mini-Percutaneous Nephrolithotomy (PCNL) compared to standard PCNL in children with nephrolithiasis. Clinical trials and observational studies comparing standard PCNL and mini-PCNL in pediatric patients were identified from electronic databases in November 2021.

Method: Studies were extracted for author, year, location, design, subjects’ age, sample size, objective, primary endpoint, level of evidence, and results (stone-free rates and complications). Results were subjected to qualitative analysis using the synthesis method. Adequate results were extracted and analyzed quantitatively using the fixed-effect model on homogenous data or the random-effect model on heterogeneous data for meta-analysis. Outcome variables are shown as odds ratios (ORs) with 95% confidence intervals (CIs). All statistical analyses were performed with Review Manager version 5.4.

Result: We reported that stone-free rate and residual stone vary between two studies with contrary results. However, our quantitative analysis showed an insignificant difference between both groups of stone-free rate (OR 0.75; 95% CI 0.22-2.54) and residual stone (OR 1.27; 95% CI 0.55-2.91). Complications rates were insignificantly different between mini-PCNL group and PCNL group in two studies in Clavien 1 (OR 0.65; 95% CI 0.27-1.54) and Clavien 2 grade (OR 0.48; 95% CI 0.19-1.22). In addition, pooled analysis of both complication grades was also insignificant in the difference between groups (OR 0.56; 95% CI 0.30-1.06).

Conclusion: The efficacy and safety of mini PCNL were neither superior nor inferior compared to standard PCNL in managing nephrolithiasis in pediatric patients. Moreover, mini PCNL was considered better regarding post-operative pain and tract infection; thus, mini PCNL could be considered a treatment option for pediatric patients with nephrolithiasis.

Keywords: Kidney stone Pediatric mini-PCNL standart PCNL efficacy Safety Complication

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How to Cite

Aulia, K., Atmoko, W., Birowo, P., & Rasyid, N. (2022). Comparison between mini-Percutaneous Nephrolithotomy (PCNL) and standard PCNL in pediatric patients: a systematic review and meta-analysis. Bali Medical Journal, 11(3), 1331–1338. https://doi.org/10.15562/bmj.v11i3.3563
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