A single centre experience of percutaneous nephrolithotomy in infants and its long-term outcomes

Patil, Neehar; Javali, Tarun; Hamsa, V; Nagaraj, H.K.

doi:10.1016/j.jpurol.2021.07.026

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…No case of urine leakage or sepsis was observed in the current study. The overall complication rate in our study is comparable to the study done in Bangalore by Patil et al, which is 16% ( 25 ). However, our complication rate is relatively better than that reported by Dağgülli et al, which was 40%, including bleeding requiring blood transfusion in 10%, fever in 10%, and UTI in 20% of the patients ( 18 ).…”

Section: Discussionsupporting

confidence: 88%

“…We used a 14 Fr access sheath and 10 Fr nephroscope. Our SFR results are comparable to a study conducted in Bangalore in 2021, in which they reported their experience of minimally invasive PCNL in 24 infants, achieving an SFR of 91% ( 25 ). Our SFR results are higher than the study conducted by Dağgülli et al and Bodakci et al in which SFR results were 80% and 81.2%, respectively ( 18 , 26 ).…”

Section: Discussionsupporting

confidence: 84%

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Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Ahmad

Minallah²,

Khaliq³

et al. 2023

Front. Pediatr.

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ObjectiveTo assess the efficacy and safety of mini-percutaneous nephrolithotomy (PCNL) for small renal stones 1–2 cm in size in infants less than one year.Material and MethodsThis descriptive case series was conducted in the department of pediatric urology Institute of Kidney Diseases Peshawar, Pakistan, from March 2019 to March 2022. All the patients underwent mini-PCNL in prone position under GA with 14 Fr access sheath and 10 Fr nephroscope. Stone clearance was assessed by non-contrast CT KUB at 30th postoperative day. Patients with no residual fragments on the non-contrast CT KUB were defined as stone-free. Patients with residual fragments of any size were defined as procedure failure. Safety was determined in terms of intra and postoperative complications.ResultsA total of 51 infants were included in the study. The mean age of patients was 9.6 + 1.8 (5–12 month). The mean stone size was 15.8 + 2.7 (10–21) mm in length and 12.3 + 2.2 (8–17) mm in width. PCNL mean operative time was 51.6 ± 7.1 (40–70) minutes. Complete stone clearance at one month was observed in 46 (90.2%) patients. Residual fragments were seen in 5(9.8%) patients with a mean size of 1.6 + 0.4 (0.9–2.0) mm. None of the patients required any additional procedure for clearance of stones. In 7 (13.7%) patients, some post-operative complications were observe, all were grade I complications, including fever in 5(9.8%) and transient hematuria in 2(3.9%) patients.ConclusionMini-PCNL is a safe and effective treatment for renal stones in infants measuring 1–2 cm with high SFR and an acceptable complication rate.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Ahmad

Minallah²,

Khaliq³

et al. 2023

Front. Pediatr.

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“…The mean stone burden was 2,533 (171-9,202) mm 3 in group 1 and 5,791 (696-17,157) mm 3 in group 2 (p = 0.02). The first urological procedure was performed at a mean age of 17 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) months in group 1 and 8.6 (3-13) years in group 2.…”

Section: Resultsmentioning

confidence: 99%

“…Previous reports have demonstrated that ESWL was effective and safe in infants and young children (12,13) while other techniques (PCNL and RUS) may be more challenging and associated with significant complications, especially in the prepubertal period (14,15). Cystine stones are known to be particularly resistant to intra-or extracorporeal fragmentation (11) and no consensus has been reached regarding the preferred and age-appropriate technique.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Shockwave Lithotripsy for Cystine Stones in Children: An Observational, Retrospective, Single-Center Analysis

Vinit¹,

Khoury²,

Lopez³

et al. 2021

Front. Pediatr.

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Purpose: Cystinuria is a genetic disorder characterized by a defective reabsorption of cystine and dibasic amino acids leading to development of urinary tract calculi from childhood onward. Cystine lithiasis is known to be resistant to fragmentation. The aim was to evaluate our long-term experience with extracorporeal shockwave lithotripsy (ESWL) used as first-line urological treatment to treat cystine stones in children.Methods: We retrospectively reviewed the charts of all children who underwent ESWL for cystine stone. We assessed the 3-month stone-free rate, according to age, younger (group 1) or older (group 2) than 2 years old.Results: Between 2003 and 2016, 15 patients with a median (IQR) age at first treatment of 48 (15–108) months underwent ESWL in monotherapy. Median age was, respectively, 15 and 108 months in each group. The median (IQR) stone burden was 2,620 (1,202–8,265) mm3 in group I and 4,588 (2,039–5,427) mm3 in group II (p = 0.96). Eleven patients had bilateral calculi. ESWL was repeated on average 2.4 times, with a maximum of 4 for patients of group I, and 4.8 times, with a maximum of 9 for group II (p > 0.05). ESWL in monotherapy was significantly more efficient to reach stone-free status for children under 2 years of age: 83% vs. 6.2% (p = 0.040). The median (IQR) follow-up of the study was 69 (42–111) months.Conclusion: ESWL appears as a valid urological option for the treatment of cystine stones, in young children. Even if cystine stones are known to be resistant to fragmentation, we report 83% of stone-free status at 3 months with ESWL used in monotherapy in children under 2 years old with cystinuria. In older children, the success rate is too low to recommend ESWL as a first line approach.

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“…Management of kidney stones in infants (<1 year of age) represents an additional challenge. In a retrospective study, Patil et al [42] shared their experience with PCNL in 24 infants. With a mean stone burden of 19 mm, they achieved 91% SFR in primary PCNL that reached 100% with re-do PCNL, with no impact on renal growth or function over a median follow-up period of 12 years [42].…”

Section: Percutaneous Nephrolithotomymentioning

confidence: 99%

Paediatric stone management: innovations and standards

Quhal

Faddagh

Sılay³

et al. 2022

Current Opinion in Urology

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Purpose of reviewThe aim of this study was to discuss current trends and recent developments in the surgical management of paediatric urolithiasis. Recent findingsMedical expulsive therapy (MET) is considered as an option for the treatment of children with ureter stones. Extracorporeal shockwave lithotripsy (SWL) remains as a first option for majority of kidney stones and upper ureter stones. Advances in endourology have led to increased adoption of retrograde intrarenal surgeries (RIRS) and percutaneous nephrolithotomy (PCNL/mini-PCNL/ultra-mini-PCNL/micro-PCNL).

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A single centre experience of percutaneous nephrolithotomy in infants and its long-term outcomes

Cited by 6 publications

References 26 publications

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Safety and efficacy of minimally invasive percutaneous nephrolithotomy for infantile nephrolithiasis. Single centre experience from Pakistan

Extracorporeal Shockwave Lithotripsy for Cystine Stones in Children: An Observational, Retrospective, Single-Center Analysis

Paediatric stone management: innovations and standards

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