Outcome of Percutaneous Nephrolithotomy in Children Having Complex Stones

Gönen, Murat; Turunç, Tahsin; Öztürk, Bülent; Aygün, Cem; Özkardeş, Hakan

doi:10.1159/000251181

Cited by 19 publications

(9 citation statements)

References 21 publications

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“…Factors affecting PNL success rates were examined by Goldwasser et al and the authors reported that the size of the stone and its localization mostly affected the success rates [ 16 ]. Consistent with the literature, in terms of stone localization, we also found that the success rate in complex stones was lower than that in simple stones [ 7 , 17 , 18 , 19 , 20 ]. Our success rate in simple stones was 96.7% (single stone in pelvis or a calyx), but 45.5% in complex stones ( p < 0.001).…”

Section: Discussionsupporting

confidence: 91%

“…We thought that multiple working channels could increase the complication rates, so we created a single subcostal channel for all of our patients. The reported success rates in complex stones ranged from 61% to 89% with the use of multiple channels [ 7 , 17 , 18 , 19 , 20 ]. Netto et al reported that the success of percutaneous treatment for staghorn calculi is highly related to optimal kidney access with supracostal and multiple access approaches, despite a slight increase in the incidence of acceptable complications [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Jabrayilov

Koparal

Gürocak

et al. 2018

JCM

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In this study, we aimed to determine factors affecting the success rate of percutaneous nephrolithotomy (PNL) in children. The series consisted of 41 consecutive children operated on by the same surgical team for renal calculi with PNL between June 2002 and May 2015 in our institution. A single calyx or pelvic stone was described as simple, while calculi located in more than one location (calyx and pelvis or more than one calices) or staghorn stones were described as complex. The procedure was deemed successful if the patient was completely stone-free (SF) or had residual fragments <4 mm. Thirty-four patients were found to be SF or had residual fragments <4 mm on the postoperative first day, thus the success rate was 82.9%. In complex stones, the success rate was significantly lower (45.5%) than simple stones (96.7%) (p < 0.001). The grade of hydronephrosis (Grade 0–1 vs. Grade 2–3) also had a negative impact on the success, with rates of 92.6% vs. 64.3%, respectively (p = 0.022). Previous urological procedure history on the same side yielded a success rate of 58.3%, whereas the success rate in the primary patients was 93.1% (p < 0.001). The localization of the stone (complex vs. simple), degree of hydronephrosis, and history of previous urological procedures were found to be the factors that affected the success of the paediatric PNL.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Jabrayilov

Koparal

Gürocak

et al. 2018

JCM

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“…Radiation exposure can be prevented by using ultrasound guidance [27]; however, to our knowledge there are no reports in the literature regarding the use of ultrasound-guided PNL in infants and very young children. Similar studies reported the use of fluoroscopy in children [6,7,13,28].…”

Section: Discussionsupporting

confidence: 59%

Percutaneous Nephrolithotomy Is Highly Efficient and Safe in Infants and Children under 3 Years of Age

et al. 2010

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Objective: We aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy (PNL) in infants and small children (12–36 months). Methods: The PNL applications conducted in children <3 years of age in two centers were evaluated. Whereas pediatric PNL instrumentation was used in the first center, adult-size instrumentation was utilized in the second center. The complications were given according to the modified Clavien classification system. Results: The mean age of the patients was 22.76 months (5–36 months) and the mean body weight was 11.51 kg (6–15 kg). In twelve renal units, pediatric instrumentation was used and among these, two had miniperc. In the other eight renal units, adult-size instrumentation was employed. Except for the patient with complex renal stones, all patients were stone free after the intervention and none required a conversion to open surgery. There were grade 1–2 complications in 3 patients. The postoperative hemoglobin drop was greater in the children who underwent PNL with adult-size instrumentation. Conclusion: In this young age group, in addition to standard PNL, simultaneous bilateral PNL, tubeless PNL and in urgent cases of renal failure, urgent PNL, are safe and effective treatment modalities provided patients are selected properly and the surgeon performing the procedure has the necessary experience.

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“…Age, sex, BMI, stone size, operation time, success rate, postoperative nephrostomy tube placement, preoperative urine culture, pelvic urine culture and stone culture were compared between groups I and II. Statistical analysis with 2 for qualitative variables and Mann-Whitney U test for quantitative variables was considered significant at p ! 0.05.…”

Section: Methodsmentioning

confidence: 99%

Role of Preoperative and Intraoperative Factors in Mediating Infection Complication following Percutaneous Nephrolithotomy

Lojanapiwat

Kitirattrakarn

2011

Urol Int

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Objective: To identify the pre- and intraoperative factors that affect the development of postoperative systemic inflammatory response syndrome (SIRS) following percutaneous nephrolithotomy (PCNL). Patients and Methods: A total of 200 patients were treated with PCNL, 56 of which developed postoperative SIRS (group I) and 144 did not (group II). For these 2 groups, the patient factor, operative factor, preoperative urine culture, pelvic urine culture, and stone culture were compared. Results: Average age, stone size, operative time, success rate, and number of tubeless PCNL were not significantly different between the 2 groups. However, preoperative urine culture, pelvic urine culture, and stone culture, respectively, were positive in 66.1, 46.4 and 48.2% of the patients in group I, but only 10.4, 3.5 and 3.5% for the corresponding specimens in group II. In addition, 5 patients in group I developed clinical septic shock, 4 of which were positive for all cultures and 1 positive only for stone culture. Conclusion: Infection following PCNL is common, but only a few cases progress to septic shock. Positive preoperative urine, intraoperative pelvic urine and stone cultures are important factors indicating the development of postoperative SIRS. Intraoperative cultures are important for decision-making about the treatment of postoperative infection complications.

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Outcome of Percutaneous Nephrolithotomy in Children Having Complex Stones

Cited by 19 publications

References 21 publications

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients

Percutaneous Nephrolithotomy Is Highly Efficient and Safe in Infants and Children under 3 Years of Age

Role of Preoperative and Intraoperative Factors in Mediating Infection Complication following Percutaneous Nephrolithotomy

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