OUTCOME OF PERCUTANEOUS NEPHROLITHOTOMY IN PRE-SCHOOL AND SCHOOL-AGE CHILDREN-SINGLE CENTER EXPERIENCE
AbstractBackground: Efficacy of percutaneous nephrolithotomy in adults has been studied well in past. However, such studies are sparse within paediatric age group. As this procedure is being adopted in smaller and older children alike, we wanted to determine its safety and efficacy in two different age groups of children (preschool age and school age). Methods: The records of 59 children undergoing PCNL at our department from December 2009 to May 2017 were reviewed retrospectively. Patients were placed into 2 age groups including children ≤7 years old (group 1) and those ≥7 years (group 2). Twenty-seven patients were put in preschool group with mean age of 4.8±2.1 years while 32 patients in school age group having mean age of 11.8±4.6 years. Results: Stone size was calculated showing mean 309±55 mm2 in preschool and 324±63 mm2 in school age group respectively (p=0.1). The mean operative time was 150.1±38.7 minutes and 166.3±39.6 minutes in the preschool and school age children respectively (p=0.1). The mean length of hospital stay was 3.1±1.4 days and 2.9±1.3 days in preschool and school going children (p=0.5). The stone clearance with PCNL was seen in 96.3% (pre-school group) and 93.75% (school age group) as monotherapy (p=0.1), which increased to 100% after combining it with extracorporeal shock wave lithotripsy. Conclusion: PCNL is equally effective in both pre-school and school age groups in terms of stone free rates. Complication rates were not different between the two groups.Keywords: Renal Stones; Paediatric Nephrolithiasis; Per-cutaneous nephrolithotomy; Stone clearance
Shah AM, Kalmunkar S, Punekar SV, Billimoria FR, Bapat SD, Deshmukh SS. Spectrum of paediatric urolithiasis in Western India. Indian J Pediatr 1991;58(4):543–9.
Lee LC, Violette PD, Tailly T, Dave S, Denstedt JD, Razvi H. A comparison of outcomes after percutaneous nephrolithotomy in children and adults: A matched cohort study. J Pediatr Urol 2015;11(5):250.e1–6.
Elsobky E, Sheir KZ, Madbouly K, Mokhtar AA. Extracorporeal shock wave lithotripsy in children: Experience using two second-generation lithotripters. BJU Int 2000;86(7):851–6.
Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. The Management of stone disease. BJU Int 2002;89(Suppl 1):62–8.
Choong S, Whitfield H, Duffy P, Kellett M, Cuckow P, Van’t Hoff W, et al. The management of paediatric urolithiasis. BJU Int 2000;86(7):857–60.
Nouralizadeh A, Basiri A, Javaherforooshzadeh A, Soltani MH, Tajali F. Experience of percutaneous nephrolithotomy using adult-size instruments in children less than 5 years old. J Pediatr Urol 2009;5(5):351–4.
Woodside JR, Steven GF, Stark GL, Borden TA, Ball WS. Percutaneous stone removal in children. J Urol 1985;134(6):1166–7.
Kumar R, Anand A, Saxena V, Seth A, Dogra PN, Gupta NP. Safety and effiacy of PCNL for management of staghorn calculi in pediatric patients. J Pediatr Urol 2011;7(3):248–51.
Unsal A, Resorlu B, Kara C, Bozkurt OF, Ozyuvali E. Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 2010;76(1):247–52.
Delvecchio FC, Preminger GM. Management of residual stones. Urol Clin North Am 2000;27(2):347–54.
Wickham JE, Miller RA, Kellett MJ, Payne SR. Percutaneous nephrolithotomy: one stage or two? Br J Urol 1984;56:582–5.
Goyal NK, Goel A, Sankhwar SN, Singh V, Singh BP, Sinha RJ, et al. A critical appraisal of complications of percutaneous nephrolithotomy in paediatric patients using adult instruments. BJU Int 2014;113(5):801–10.
Saad KS, Youssif ME, Al Islam Nafi Hamdy S, Fahmy A, El Din Hanno AG, El-Nahas AR. Percutaneous Nephrolithotomy vs Retrograde Intrarenal Surgery for Large Renal Stones in Pediatric Patients: A Randomized Controlled Trial. J Urol 2015;194(6):1716–20.
Smaldone MC, Docimo SG, Ost MC. Contemporary surgical management of pediatric urolithiasis. Urol Clin North Am 2010;37(2):253–67.
Ramakumar S, Segura JW. Renal calculi. Percutaneous management. Urol Clin North Am 2000;27(4):617–22.
Holman E, Khan AM, Flasko T, Toth C, Salah MA. Endoscopic management of pediatric urolithiasis in a developing country. Urology 2004;63(1):159–62.
Boormans JL, Scheepe JR, Verkoelen CF, Verhagen PC. Percutaneous nephrolithotomy for treating renal calculi in children. BJU Int 2005;95(4):631–4.
Gunes A, Yahya Ugras M, Yilmaz U, Baydinc C, Soylu A. Percutaneous nephrolithotomy for pediatric stone disease - our experience with adult-sized equipment. Scand J Urol Nephrol 2003;37(6):477–81.
Samad L, Aquil S, Zaidi Z. Paediatric percutaneous nephrolithotomy: setting new frontiers. BJU Int 2006;97(2):359–63.
Aron M, Yadav R, Goel R, Hemal AK, Gupta NP. Percutaneous nephrolithotomy for complete staghorn calculi in preschool children. J Endourol 2005;19(8):968–72.
Celik H, Camtosun A, Dede O, Dagguli M, Altintas R, Tasdemir C. Comparison of the results of pediatric percutaneous nephrolithotomy with different sized instruments. Urolithiasis 2017;45(2):203–8.
Celik H, Camtosun A, Altintas R, Tasdemir C. Percutaneous nephrolithotomy in children with pediatric and adult-sized instruments. J Pediatr Urol 2016;12(6):399.
Bodakci MN, Daggülli M, Sancaktutar AA, Söylemez H, Hatipoglu NK, Utangaç MM, et al. Minipercutaneous nephrolithotomy in infants: a ssingle-center experience in an endemic region in Turkey. Urolithiasis 2014;42(5):427–33.
Agrawal MS, Agarwal K, Jindal T, Sharma M. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stoneremoval. Indian J Urol 2016;32(2):132–6.
Kaygısız O, Satar N, Güneş A, Doğan HS, Erözenci A, Özden E, et al. Factors predicting postoperative febrile urinary tract infection following percutaneous nephrolithotomy in prepubertal children. J Pediatr Urol 2018;14(5):448.
Pelit ES, Atis G, Kati B, Akin Y, Çiftçi H, Culpan M, et al. Comparison of Mini-percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery in Preschool- aged Children. Urology 2017;101:21–5.
Song G, Guo X, Niu G, Wang Y. Advantages of tubeless mini-percutaneous nephrolithotomy in the treatment of preschool childrenunder 3 years old. J Pediatr Surg 2015;50(4):655–8.
Xiao B, Zhang X, Hu WG, Chen S, Li YH, Tang YZ, et al. Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China. Chin Med J (Engl) 2015;20;128(1596–600.
Senocak C, Ozbek R, Bozkurt OF, Unsal A. Predictive factors of bleeding among pediatric patients undergoing percutaneous nephrolithotomy. Urolithiasis 2018;46(4):383–9.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.