COMPARATIVE ANALYSIS OF MINI PERCUTANEOUS NEPHROLITHOTOMY VERSUS STANDARD PERCUTANEOUS NEPHROLITHOTOMY IN TERMS OF STONE FREE RATES, HOSPITAL STAY AND POST-OPERATIVE COMPLICATIONS IN PEDIATRIC POPULATION: A SYSTEMATIC REVIEW

In the last decade, the number of children with nephrolithiasis increased to 50 cases per 100,000. Percutaneous nephrolithotomy (PNCL) has been shown to be a successful treatment. However, standard PCNL has resulted in a number of problems, in pediatric patients, because to the large nephroscope and amplatz size of 24-30 F. Aim of this systematic review was to compare available literature of Mini PCNL and Standard PCNL to assess efficacy and Stone free rates (SFR) in pediatric population. In this systematic review and meta-analysis investigating the effect of different amplatz sheath sizes for percutaneous nephrolithotomy (PCNL) in pediatric population. Our report follows the PRISMA protocol. A methodical search was conducted using multiple databases of research-based literature including PubMed, Cochrane, Google Scholar, and Web of Sciences. Statistical Package for Social Sciences (SPSS) version 22 and STRATA were used to sort, analyze, and present data graphically. Stone free rates were reportedly higher in standard PCNL in three (3/6) studies with 93.7% / 91.7%, 83.4% / 74.9% and 94.7% / 89.5% while all other studies reported mini PCNL SFR higher than Standard PCNL with 75.8% / 71.4% , 90.5% / 85.7 and 87.9% / 59.1% respectively. Multivariate analysis was reported in only 1 study with coefficient of 0.079 and 95% CI as 0.944 - 1.241 (Lower - Upper). When it comes to managing both simple and difficult renal calculi in children, mini-PCNL is just as safe and successful as SPCNL, with similar operational times, SFRs, and total problems.