Percutaneous Nephrolithotomy in Children: 17 Years of Experience

Çıtamak, Burak; Altan, Mesut; Bozacı, Ali Cansu; Koni, Artan; Doğan, Hasan Serkan; Bilen, Cenk Yücel; Şahin, Ahmet; Tekgül, Serdar

doi:10.1016/j.juro.2015.11.070

Cited by 17 publications

(12 citation statements)

References 22 publications

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“…In addition, based on evidence from an American nationwide in-patient study, urgent decompression has been directly associated with a decrease in mortality in patients with sepsis and ureteral calculi (29). In terms of surgery, a number of studies have reviewed the risk factors for the occurrence of postoperative sepsis and mortality following endourological treatment: Presence of kidney stones; large stone burden; female sex; diabetes mellitus; renal insufficiency; high pressure in the collecting system; and long surgery times were identified to be risk factors for sepsis following operation (9)(10)(11)30). Wu et al (12) demonstrated an association between the early marked decrease in WBC count and uroseptic shock induced by upper urinary tract endoscopic lithotripsy.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical procedure. The methods used to perform PCNL, URL and emergency ureteroscopic double J stenting procedures were analogous with other previously described methods (11,12,23). Patients with obstructive urolithiasis and suspected urosepsis, as diagnosed by the emergency physicians, were transferred to the urology department.…”

Section: Methodsmentioning

confidence: 99%

“…Urosepsis is defined as sepsis caused by a urogenital tract infection and it may be caused by urinary tract obstruction or complication following surgical interventions (6)(7)(8). Urolithiasis-associated sepsis, caused by obstructive upper ureteral calculi or postoperative complications following percutaneous nephrolithotomy (PCNL), ureteroscopic lithotripsy (URL) and laparoscopic lithotomy, is a severe global problem in the field of urology (9)(10)(11)(12)(13). To the best of our knowledge, there is no consensus on whether the Sepsis-3 criteria are an effective prognostic tool for patients with urolithiasis-associated sepsis.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

Shi

et al. 2019

Exp Ther Med

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The aim of the present study was to validate the prognostic effectiveness of Sepsis-3 criteria, including sequential organ failure assessment (SOFA) and quick SOFA (qSOFA), with systemic inflammatory response syndrome (SIRS) criteria among patients with urolithiasis associated sepsis that were transferred to intensive care unit (ICU) facilities following surgical interventions. To achieve this, the records of all patients transferred to ICU following surgical interventions with urolithiasis-associated sepsis between January 2010 to July 2017 at Xin Hua Hospital Affiliated to Shanghai Jiao Tong University were retrospectively reviewed. A total of 107 patients were enrolled. The prognostic performances of SOFA, qSOFA and SIRS for predicting in-hospital mortality (sepsis-related mortality during patients' hospitalizations) or prolonged length of ICU stay (>3 days) were compared using the area under the receiver operating characteristic curve (AUROC) and Z statistic values. The results revealed that the overall in-hospital mortality rate was 8.4% and the percentage of in-hospital mortality or prolonged length of ICU stay (>3 days) was 72.0% among the 107 patients. The favorable outcome group exhibited significantly decreased white blood cell counts, and levels of C-reactive protein and procalcitonin and increased systolic blood pressure and mean arterial pressure. The AUROC of qSOFA, SIRS and SOFA were 0.615, 0.625 and 0.860, respectively. SOFA was significantly more effective at predicting adverse outcomes when compared with SIRS and qSOFA criteria. Following adjustments for patient age and comorbidities, the AUROC values of qSOFA, SIRS and SOFA were 0.713, 0.722 and 0.940. In conclusion, the results of the present study indicate that the prognostic performance of SOFA for predicting in-hospital mortality or prolonged ICU stay among patients with urolithiasis-associated sepsis following surgical interventions was significantly improved when compared with qSOFA or SIRS criteria. Based on these results it is recommended that urologists use the SOFA score for patients with urolithiasis-associated sepsis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

Shi

et al. 2019

Exp Ther Med

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“…Entfernung (Nephrolithotomie) entsteht durch primär infizierten Urin ("Infektsteine") bei konkomittanten angeborenen Fehlbildungen wie z. B. VUR [23] ( ▶ Abb. 4).…”

Section: Nephrolithiasis Und Urosepsisunclassified

Urosepsis bei Kindern und Jugendlichen – konservative und operative Therapie

Oswald

2017

Aktuel Urol

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Urinary tract infections (UTI) are the most common infectious diseases in children. Urosepsis in childhood, though rare, is the most complicated possible variant. In newborns and infants, unspecific symptoms are a significant barrier to a fast and reliable diagnosis, which is crucial to successful treatment. In addition to urine and laboratory tests as well as non-invasive examinations (ultrasound), there may be an indication for invasive examinations of the kidneys (DMSA scans) in cases of a severe infection. Conservative therapy consists of targeted parenteral antibiotic treatment and paediatric sepsis management. Surgical desobstruction and urinary diversion are indicated if conservative therapy has failed. In addition to catheterised drainage of the upper and lower urinary tract, open surgery techniques are used in due consideration of the child and situation. Also, causal factors such as congenital malformations of the urinary system leading to impaired urinary drainage (vesicoureteral reflux, obstruction) have to be evaluated and treated.

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“…When combined with increased surgical experience, this method has proven to be effective and reliable in anatomically difficult cases, such as pediatric patients and patients with skeletal deformities or morbid obesity, that can complicate surgery. [2][3][4] However, the number of studies in the literature describing PCNL in the different age patients is limited. 5,6 In the present century, average life expectancy has lengthened considerably with rapidly evolving technology and innovations in the field of medicine.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the results of percutaneous nephrolithotomy in different age groups

et al. 2018

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Background: Evaluation of feasibility, safety and effectiveness of percutaneous nephrolithotomy (PCNL) in different age groups.Methods: Between July 1997-October 2012, 233 patients who were 65 years old and older were included in this study. These patients were divided into two age subgroups used in gerontology research. Group 1 was defined as patients 65-74 years old, Group 2 was older than 74 years old. Data from patient records, including demographic characteristics, preoperative evaluation, operative details, and complications were retrospectively analyzed and compared with control group data.Results: The mean age of 233 patients was 69.7±4.6 years. The mean operative times for Group 1, group 2 and the control group were 76.2±47.3mins, 92.9±47.6mins, 77±44mins, respectively and there was no statistically significant difference between groups 1 and 2 and the control group (p>0.05). Twenty-eight of the 233 patients (12%) needed blood transfusion due to perioperative bleeding. The transfusion rates of groups 1 and 2 were 11.3% and 16.7%, respectively. There was no statistically significant difference between the study groups and control group for blood transfusion rates (p>0.05). There was no statistically significant difference in complications between the study and control groups (p>0.05).Conclusions: In geriatric patients, stone-free rates, transfusion rates and other operation parameters are similar to younger populations when experienced surgeons perform PCNL. Despite comorbidities and decreased body reserve, PCNL can be performed without a significant increase in complications in different ages.

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Percutaneous Nephrolithotomy in Children: 17 Years of Experience

Abstract: As in adults, percutaneous nephrolithotomy can be used in children with acceptable complication rates and good success rates for surgical treatment of complex renal stones. Number of stones and stone burden are predictive of postoperative stone-free rate.

Cited by 17 publications

References 22 publications

The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

The prognostic performance of Sepsis‑3 and SIRS criteria for patients with urolithiasis‑associated sepsis transferred to ICU following surgical interventions

Urosepsis bei Kindern und Jugendlichen – konservative und operative Therapie

Comparison of the results of percutaneous nephrolithotomy in different age groups

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