Pediatric mini-percutaneous nephrolithotomy using self-retained screwed amplatz sheath versus ordinary sheath

Objective: to evaluate the use of a new 16f mini-screwed sheath in pediatrics in comparison to a 16f ordinary Amplatz sheath. Methods: 67 patients less than 18 years with renal calculi between 1-2 cm who was a candidate for mini-perc between January 2019 and September 2021 were randomized by closed envelope in group A (34 patients) using new mini-screwed sheath and group B (33 patients) with ordinary mini-sheath. patients with contraindications for PNL were excluded. Results: No significant difference was present between both groups according to patients and stone demographics. There was no significant difference between both groups regarding puncture site and number. The mean operative time was (51.25±2.15 min.) and (52.35±3.45 min.) in both groups respectively. The fluoroscopy time was significantly lower in group A (2.1±0.85 min) than in group B (2.9 ± 1.05 min). Tract loss was 18.2% in group B while 0% in group A. Although bleeding was less in group A, it was non-significant. The stone-free rate was (94.11%) and (90.9 %) in group A and group B respectively. Conclusion: Screwed sheath enables the urologist to have a stable track during pediatric mini-perc surgery despite the thin abdominal wall in the pediatric. The screw sheath provides significantly lower fluoroscopy time and decreases the need for nephrostomy tube insertion when compared with ordinary sheath in mini perc renal surgery Keywords: Screwed sheath; mini-percutaneous nephrolithotomy; PNL complications and PNL outcomes.