Safety and Efficacy of Percutaneous Nephrolithotomy in Children

Abstract

Background: Renal stone disease is a common problem in children in developing countries. Its prevalence in children varies from 5% to 15%. It is suggested that anatomic abnormalities, recurrent urinary tract infections, metabolic disturbances, dietary and environmental factors are the predisposing factors.The aim of this study is to evaluate the safety and efficacy of percutaneous nephrolithotomy in children.Methods: Between May 2012 and Dec 2016, 25 children with renal stone diseases underwent percutaneous nephrolithotomy and were evaluated for stone free rate, complications, blood transfusion rate, sandwich therapy, etc.Results: The mean age of children was 9.3 years (7-15 years) and the mean size of the stone was 20 mm (13-27 mm). The anatomical location of stone was important in terms of stone clearance. Three patients needed blood transfusion. The overall stone free rate was 88% before discharge. Three patients had residual stones and were treated with extracorporeal shockwave lithotripsy. Complications included fever, haematuria, ileus and urine leak. No major complications were noted. There were no significant differences in haemoglobin and creatinine levels before and 12 hours after the surgery.Conclusions: Percutaneous nephrolithotomy (PCNL) can be considered a safe, effective and feasible modality of treatment for children with an average of 2 cm sized renal stones.

Evaluation of the efficacy and safety of percutaneous nephrolithotomy in children

“…Dongol et al reported a stone free rate of 88% in a study of 25 children with complication rate of 12%. 13 Higher rate of 30.3% has been reported by Mousavi-Bahar et al which included severe complications renal parenchymal and duct injury, colon perforation, damage to major vessels, pneumothorax and hemothorax. 14 Fever has been reported as common postoperative complication which was seen in 12.3% patients in our study.…”

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“…Our length of hospital stay duration of nephrostomy tube in situ is comparable to previously published data. 42.85% of our cases were tubeless, which is safe when performing uncomplicated PCNL [26][27][28][29][30][31][32][33][34]. Prior renal surgery on the same side didn't have any impact on outcome of PCNL [35].…”

Treatment Characteristics of Kidney Stone Disease in Children

“…Согласно данным U.M.S. Dongol и соавт., основными осложнениями ЧНЛТ являются гематурия, требующая переливания компонентов крови (12%), лихорадка (30%), требующая антибактериальной терапии, повреждение висцеральных органов: печени [25], селезенки [26], желчного пузыря [27], толстой кишки, а также плеврального синуса (8%) [28]. При этом следует отметить, что в настоящее время назначение пери-и послеоперационной антибиотикотерапии, на наш взгляд, является целесообразным для всех пациентов при проведении ЧНЛТ вне зависимости от выраженности лихорадки для профилактики гнойно-воспалительных осложнений.…”