Vacuum-assisted versus conventional percutaneous sheaths in pediatric supine mini-PCNL: a comparative analysis.

Authors

Bilge Turedi, Ali Sezer, Mehmet Serkan Ozkent, Mustafa Bilal Hamarat, Kemal Sarica

Published in

Urolithiasis. Volume 54. Issue 1. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

Vacuum-assisted access sheaths have recently gained interest in percutaneous stone surgery; however, data regarding their use in pediatric patients remain limited. This study compared the perioperative and postoperative outcomes of vacuum-assisted and conventional percutaneous access sheaths in pediatric patients undergoing supine mini-percutaneous nephrolithotomy. Medical records of children younger than 18 years who underwent supine mini-percutaneous nephrolithotomy between January 2022 and January 2026 were retrospectively reviewed. Patients with anatomical anomalies, bilateral procedures, multiple access tracts, or endoscopic combined intrarenal surgery were excluded. A total of 51 patients were included and divided into two groups according to sheath type: conventional percutaneous access sheaths (n = 27) and vacuum-assisted ClearPetra sheaths (n = 24). Baseline demographic and stone characteristics were comparable between the groups. Mean operative time was shorter in the vacuum-assisted group (57.6 ± 21 vs. 65.6 ± 24 min, p = 0.232), whereas fluoroscopy time was slightly longer (74.2 ± 65 vs. 60.6 ± 44 s, p = 0.387); neither difference reached statistical significance. Stone-free rates were comparable between the conventional and vacuum-assisted groups (85.2% vs. 91.7%, p = 0.473). Overall complication rates were low and similar (25.9% vs. 16.7%, p = 0.541). A lower rate of postoperative fever was observed in the vacuum-assisted group; however, this difference did not reach statistical significance (4.2% vs. 18.5%, p = 0.112). All cases resolved with medical treatment. No aspiration-related morbidity was observed. No statistically significant differences in operative or postoperative outcomes were observed between vacuum-assisted access using the ClearPetra sheath and conventional access sheaths in pediatric patients undergoing supine mini-percutaneous nephrolithotomy. Larger prospective studies are needed to determine whether vacuum-assisted access provides clinically meaningful advantages.

PMID:
42696162
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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