Pediatric Percutaneous Nephrolithotomy—Experience of a Tertiary Care Center

Yadav, Sher Singh; Aggarwal, Satinder Pal; Mathur, Rajendra Mohan; Sharma, Krishan Kumar; Yadav, Ram Gopal; Tomar, Vinay; Teli, Ram Dayal; Jain, Deepak

doi:10.1089/end.2015.0842

Cited by 14 publications

(11 citation statements)

References 29 publications

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“…Factors affecting PNL success rates were examined by Goldwasser et al and the authors reported that the size of the stone and its localization mostly affected the success rates [ 16 ]. Consistent with the literature, in terms of stone localization, we also found that the success rate in complex stones was lower than that in simple stones [ 7 , 17 , 18 , 19 , 20 ]. Our success rate in simple stones was 96.7% (single stone in pelvis or a calyx), but 45.5% in complex stones ( p < 0.001).…”

Section: Discussionsupporting

confidence: 91%

“…We thought that multiple working channels could increase the complication rates, so we created a single subcostal channel for all of our patients. The reported success rates in complex stones ranged from 61% to 89% with the use of multiple channels [ 7 , 17 , 18 , 19 , 20 ]. Netto et al reported that the success of percutaneous treatment for staghorn calculi is highly related to optimal kidney access with supracostal and multiple access approaches, despite a slight increase in the incidence of acceptable complications [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Jabrayilov

Koparal

Gürocak

et al. 2018

JCM

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In this study, we aimed to determine factors affecting the success rate of percutaneous nephrolithotomy (PNL) in children. The series consisted of 41 consecutive children operated on by the same surgical team for renal calculi with PNL between June 2002 and May 2015 in our institution. A single calyx or pelvic stone was described as simple, while calculi located in more than one location (calyx and pelvis or more than one calices) or staghorn stones were described as complex. The procedure was deemed successful if the patient was completely stone-free (SF) or had residual fragments <4 mm. Thirty-four patients were found to be SF or had residual fragments <4 mm on the postoperative first day, thus the success rate was 82.9%. In complex stones, the success rate was significantly lower (45.5%) than simple stones (96.7%) (p < 0.001). The grade of hydronephrosis (Grade 0–1 vs. Grade 2–3) also had a negative impact on the success, with rates of 92.6% vs. 64.3%, respectively (p = 0.022). Previous urological procedure history on the same side yielded a success rate of 58.3%, whereas the success rate in the primary patients was 93.1% (p < 0.001). The localization of the stone (complex vs. simple), degree of hydronephrosis, and history of previous urological procedures were found to be the factors that affected the success of the paediatric PNL.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Jabrayilov

Koparal

Gürocak

et al. 2018

JCM

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“…Complications according to the Clavien classification were reported in 29.2% of the adults by Tefekli et al [17] and in 30% of children by Ozden et al [18]. Yadav et al reported complication in 21.66% of cases and the majority of patients (97.9%) had minor complications (Clavien grade 1 & 2) [19]. In our study, complications emerged in 5 children (6.3%).…”

Section: Discussionsupporting

confidence: 56%

Outcomes of mini-percutaneous nephrolithotomy in children: a single centre experience

Kandemir

Balasar

Pişkin

et al. 2019

Cent european J Urol

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Introduction The aim of this study was to present to present our experiences with pediatric mini-percutaneous nephrolithotomies (MPNL) in our center. Material and methods A total of 85 MPNLs performed on 79 pediatric patients being treated for upper urinary tract stones from 2007 to 2017 were analyzed retrospectively in order to determine their safety, efficacy, and relevant outcomes. Results 85 MPNLs performed on 79 patients with a mean age of 6.58 (1–14) years were included in this study. The mean size of the stones was 1.99 (1–6.4) mm. A 17 Fr rigid pediatric nephroscope with a pneumatic intracorporeal lithotripsy was used through a 20 Fr access sheath. The stone-free rate was 87.1% at 1 month postoperatively. Mean operative time was 56.4 (20–120) min. Mean fluoroscopy screening time was 183.2 (40–510) sec. Average hospitalization duration was 4.78 (2–13) days. Auxiliary procedures were performed on 7 (8.2%) patients (5 extracorporeal shock wave lithotripsy, 2 re- percutaneous nephrolithotomy). The complication rate of these cases was 6.3% according to the modified Clavien Classification System. However, no major complications classified as Clavien IV–V were observed in the study group. Conclusions The outcomes of the contemporary analysis confirm that MNPL is a safe and efficient method of intervention resulting in a stone-free state in pediatric cases.

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“…Many studies have proved the safety and efficacy of PCNL in pediatric patients, but most of these studies are performed with adult-size instruments. [ 8 9 10 ] Kapoor et al . used an adult-size sheath from 24 to 30 Fr in children and achieved a stone-free rate of 74.2% in a single session, which improved to 83.9% after the second procedure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of mini-percutaneous nephrolithotomy by standard and miniperc instruments in pediatric population: A single-center experience

Mahajan¹,

Mahajan²

2021

J Indian Assoc Pediatr Surg

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Objective: The objective of this study was to compare mini-percutaneous nephrolithotomy (PCNL) performed by standard and Miniperc techniques in pediatric patients. Materials and Methods: This was a retrospective study conducted at our institution between January 2012 and December 2017. The outcomes of pediatric renal stones treated by mini-PCNL done by Miniperc and standard techniques were compared in terms of the drop in the hemoglobin, stone-free rate, and analgesic requirement in the first 24 h. Results: A total of 57 children (age: 1–16 years), who underwent mini-PCNL by Miniperc equipment ( n = 23) and standard equipment ( n = 34), were included in this study. The postoperative mean drop in hemoglobin was significantly higher in mini-PCNL done by standard compared to the Miniperc technique. The stone-free rate was 95.65% in the Miniperc group and 94.12% in the standard mini-PCNL group. The need for analgesics was significantly lower in the Miniperc group compared to the standard mini-PCNL group ( P = 0.0002). In the Miniperc group, the majority of the patients required only one dose of analgesics, whereas, in the standard mini-PCNL group, around 44% of the patients required three or more than three doses of analgesics to reduce postoperative pain. Conclusion: Both the techniques were safe and efficacious in the management of pediatric renal stone and stone clearance. However, the Miniperc technique resulted in significantly less pain and a lower dosage of analgesics.

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Pediatric Percutaneous Nephrolithotomy—Experience of a Tertiary Care Center

Cited by 14 publications

References 29 publications

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Outcomes of mini-percutaneous nephrolithotomy in children: a single centre experience

Comparison of mini-percutaneous nephrolithotomy by standard and miniperc instruments in pediatric population: A single-center experience

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