Percutaneous Nephrolithotomy in Children

Schuster, Tina K.; Smaldone, Marc C.; Averch, Timothy D.; Ost, Michael C.

doi:10.1089/end.2009.0198

Cited by 37 publications

(19 citation statements)

References 34 publications

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“…While the smaller caliber percutaneous tract and nephroscope are considered to be less injurious to the kidney and furthermore underdilates and avoids torturing, important considerations in preventing bleeding and renal trauma [3,4,[9][10][11][12][13], there are studies claiming that adult equipment in PNL is compatible for use in infants and small children [8]. The PNL techniques and instrumentation reported in the present study differ, as they were applied in two centers.…”

Section: Discussionmentioning

confidence: 99%

“…The overall stone free rate was 94.7%. The reported stone free rates of PNL monotherapy in the recent literature range from 86 to 98% [3,4,[9][10][11]. These rates increase with adjunctive procedures such as secondlook PNL, SWL and ureteroscopy.…”

Section: Discussionmentioning

confidence: 99%

“…However, the development and commonplace use of PNL in pediatrics has been slower and more cautious [2][3][4]. The first successful usage of pediatric PNL was reported in children with a mean age of 14 years, whose bodily dimensions were comparable to those of adults [5].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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“…The reasons for a progressive shift toward PCNL for treating staghorn calculi in children are the high clearance rate of 80-90% and avoiding multiple procedures and hospital visits [13,14]. PCNL in children as young as 3 months was reported as safe and efficacious [15].…”

Section: Introductionmentioning

confidence: 99%

Mini-Percutaneous Nephrolithotomy for Complex Staghorn Stones in Children

Rashid¹,

Amin²,

Kadum³

et al. 2019

Urol Int

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Objectives: To evaluate the safety and efficacy of percutaneous mini-nephrolithotomy (mini-PCNL) in children with complex staghorn stones. Patients and Methods: We analyzed prospectively data of 28 children undergoing pediatric mini-PCNL during a period of 18 months. Stone complexity was defined according to the validated Guy’s stone score (GSS). Our patients were GSS III and IV. All PCNL procedures were performed in the prone position, under fluoroscopic guidance, and in the same standardized fashion with F12 and F17 mini-nephroscopes. Results: Eleven children were boys (total n = 28). Mean age was 7.25 ± 3.27 (2–14) years. Mean stone burden was 36.89 ± 8.002 (30–60) mm. GSS was in 57% grade III and in 43% grade IV. The initial stone-free rate was 78%, which increased to 89% after few ancillary procedures. Seventeen percent of children had major complications (1 hydrothorax, 4 blood transfusions). On statistical analysis, stone clearance rates were found inversely dependent on stone complexity (GSS; p < 0.025). Stone burden, number of tracts, and procedure time were associated with stone complexity (p < 0.000). In turn, stone complexity (p < 0.015) and the number of tracts (p < 0.049) were significantly associated with complications. Conclusion: Mini-PCNL is effective and safe for treating complex renal stones in pediatric patients. Complication rates are acceptable and predictably stable on comparison with the literature.

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“…Previously, different studies assessed the safety and efficacy of PCNL in children and healthy adult patients (with no comorbidity) [1,2,3,4], but there are a few reports about surgical outcomes and postoperative complications in high-risk patients (with one or more systemic diseases).…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Nephrolithotomy in High-Risk Patients: A Single-Center Experience with More than 350 Cases

Nouralizadeh¹,

Lashay²,

Ziaee³

et al. 2013

Urol Int

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Purpose: To assess the surgical outcomes and peri- and postoperative complications following percutaneous nephrolithotomy (PCNL) in high- and low-risk patients according to the American Society of Anesthesiologists (ASA) score. Materials and Methods: We reviewed the patient records of 2,281 cases older than 18 years who had undergone PCNL in the 3 previous years. The patients were divided into two groups: a low-risk group (ASA score 1, 2: 1,922 cases) and a high-risk group (ASA score 3, 4: 359 cases). Results: Analysis of the location and size of the stone, number and type of access, surgical approach, post-PCNL serum hemoglobin and decrease in glomerular filtration rate revealed no significant difference between the two groups. The stone-free rate was similar in both groups and the hospital stay in the high-risk patients was significantly greater than in the low-risk cases. 95% of low-risk and 91% of high-risk cases had surgical complications compatible with grade ≤II (Clavien system) and overall distribution of different grades of surgical complications was similar between the two groups (p = 0.177). Conclusion: Success rate and surgical complications of PCNL in high-risk patients were comparable to low-risk patients. It seems that PCNL may be a safe and effective procedure even in high-risk patients.

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Percutaneous Nephrolithotomy in Children

Abstract: Technologic advancements and refinements in technique have facilitated the successful application of PCNL in the pediatric population. As a result, PCNL has now replaced open surgery as the treatment of choice for large stone burdens in children of all ages.

Cited by 37 publications

References 34 publications

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

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

Mini-Percutaneous Nephrolithotomy for Complex Staghorn Stones in Children

Percutaneous Nephrolithotomy in High-Risk Patients: A Single-Center Experience with More than 350 Cases

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