Numan Baydilli1, Halil Tosun2, Emre Can Akınsal1, Abdullah Gölbaşı1, Sibel Yel3, Deniz Demirci1. 1. Department of Urology, Erciyes University School of Medicine, Kayseri, Turkey. 2. Department of Pediatric Urology, University of Health Sciences, Ankara Child Health and Disease Hematology Oncology Research Hospital, Ankara, Turkey. 3. Department of Pediatric Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
Abstract
OBJECTIVE: To evaluate the efficacy and complications of mini-percutaneous nephrolithotomy (PCNL) surgery using 14-20 Fr access sheaths in pediatric patients, as well as the results of postoperative stone analysis and metabolic urine analysis. MATERIAL AND METHODS: We retrospectively evaluated the records of 206 pediatric patients (232 kidney units) who underwent mini-PCNL for kidney stones in our clinic between February 2011 and December 2018. We evaluated the demographic characteristics, complications, stone-free rates, and the results of chemical analysis and urinary metabolic analysis. RESULTS: The age ranged from 9 months to 16 years. The mean age was 5.1±3.9 years, and the median age was 3.5 years. The median stone burden was 200 mm2 (min: 100; max: 1600). Kidney stones were most commonly located in the pelvis in 118 (50.9%) patients, followed by lower calyceal stones in 42 (18.1%) and multiple calyceal stones in 38 (16.4%) patients, respectively. While the success of mini-PCNL was 80.6% after the first session, this rate increased to 87.9% after auxiliary treatments. The total complication rate was 12.9% according to modified Clavien classification. A postoperative stone analysis showed that calcium oxalate had the highest frequency with 61.1% of patients, followed by cystine stone with 21.3% of patients. Metabolic urine analysis revealed no abnormalities in 42.8% of patients. The most common metabolic abnormality was hyperoxaluria (32%), followed by hypercalcuria (19.6%). CONCLUSION: Mini-PCNL is a safe and effective procedure with reasonable complications for the treatment of pediatric kidney stones. All kinds of multidisciplinary efforts are required to remove kidney stones completely in pediatric patients.
OBJECTIVE: To evaluate the efficacy and complications of mini-percutaneous nephrolithotomy (PCNL) surgery using 14-20 Fr access sheaths in pediatric patients, as well as the results of postoperative stone analysis and metabolic urine analysis. MATERIAL AND METHODS: We retrospectively evaluated the records of 206 pediatric patients (232 kidney units) who underwent mini-PCNL for kidney stones in our clinic between February 2011 and December 2018. We evaluated the demographic characteristics, complications, stone-free rates, and the results of chemical analysis and urinary metabolic analysis. RESULTS: The age ranged from 9 months to 16 years. The mean age was 5.1±3.9 years, and the median age was 3.5 years. The median stone burden was 200 mm2 (min: 100; max: 1600). Kidney stones were most commonly located in the pelvis in 118 (50.9%) patients, followed by lower calyceal stones in 42 (18.1%) and multiple calyceal stones in 38 (16.4%) patients, respectively. While the success of mini-PCNL was 80.6% after the first session, this rate increased to 87.9% after auxiliary treatments. The total complication rate was 12.9% according to modified Clavien classification. A postoperative stone analysis showed that calcium oxalate had the highest frequency with 61.1% of patients, followed by cystine stone with 21.3% of patients. Metabolic urine analysis revealed no abnormalities in 42.8% of patients. The most common metabolic abnormality was hyperoxaluria (32%), followed by hypercalcuria (19.6%). CONCLUSION: Mini-PCNL is a safe and effective procedure with reasonable complications for the treatment of pediatric kidney stones. All kinds of multidisciplinary efforts are required to remove kidney stones completely in pediatric patients.
Authors: Ahmed Farouk; Ahmed Tawfick; Mohamed Shoeb; Mahmoud A Mahmoud; Diaa Eldin Mostafa; Mohamed Hasan; Hany M Abdalla Journal: World J Urol Date: 2018-02-15 Impact factor: 4.226