Percutaneous Stone Removal in Children

Woodside, Jeffrey R.; Stevens, Gerald F.; Stark, George L.; Borden, Thomas A.; Ball, William S.

doi:10.1016/s0022-5347(17)47669-5

Cited by 200 publications

(90 citation statements)

References 5 publications

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“…They have been used both as monotherapy and combined as dual therapy [5,6]. The first paediatric PCNL series was reported in 1985 [7], and included seven children with a mean (range) age of 14 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years, treated using instruments for adults and with no significant complications. Since then much work has been done on paediatric urolithiasis, but few centres have reported their experience of PCNL in infants and very young children [6,8].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous nephrolithotomy in children before school age: experience of a Pakistani centre

Zaidi

2004

BJU International

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RESULTSThere were 30 renal units in 29 children (median age 3.8 years, range 1.4-5). Because of poor growth the mean ( SD ) body weight of the children was only 12.2 (2.8) kg, which is near the 50th percentile for children of mean age 3.5 years. The median (range) stone burden was 2.35 (1.3-6) cm; 60% of the patients had single stones while 28% had more than five. There were five staghorn stones. All PCNL was primary and with one puncture, using a 17 F angled nephroscope; stones were fragmented using a pneumatic lithoclast. After PCNL stones were completely cleared in 60% of the renal units, which increased to 100% after combining it with extracorporeal shockwave lithotripsy. The median (range) follow-up was 24.9 (4-51) months; the overall complication rate was 6%. In the long follow-up hypertension was not detected in any child and isotopic renograms in 17 kidneys detected no new scarring or loss of renal function. CONCLUSIONPCNL is a safe and effective for treating renal stones in very young children. KEYWORDS PCNL, renal stones, pre-school children OBJECTIVETo review our experience of percutaneous nephrolithotomy (PCNL) in children before school age, and determine its efficacy and safety in this age group. PATIENTS AND METHODSThe records of children aged £ 5 years undergoing PCNL were reviewed. Variables assessed included stone number, size, location and type. The PCNL puncture site and number were also recorded. We reviewed stone clearance with PCNL, ancillary procedures used, complication rates and follow-up status of the children.

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Section: Introductionmentioning

confidence: 99%

Percutaneous nephrolithotomy in children before school age: experience of a Pakistani centre

Zaidi

2004

BJU International

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“…The first PNL operation was performed in 1985 (10) Table 1. PNL results in the age groups below and abovefor whom ESWL or RIRS is unsuccessful, PNL should be the first line of treatment.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy Results in Pediatric Kidney Stone Disease in Patients Under the Age of 10 Years and in Patients Over the Age of 10 Years

Çelik¹,

Ediz²,

Çamtosun³

et al. 2016

JAREM

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INTRODUCTIONUrinary tract stones are seen at all ages, and its frequency is gradually increasing in our country. Some factors such as changes in dietary habits, diet rich in carbohydrates and salt, and increase in obesity have a role in the increased frequency of urinary tract stones in pediatric patients. Moreover, due to the sedentary lifestyles of children because of televisions and computers and with improving technology, better scanning and early-diagnosis alternatives have become more efficient (1). Metabolic and anatomic disorders are among the factors involved in the formation of stones in pediatric patients. At present, pediatric urinary tract stone is included in the urology practice more often because parents are more interested in diagnosis-treatment opportunities. Our main goal is to reach maximum stone-free rates in this age group through minimally invasive methods. Therefore, the importance of percutaneous nephrolithotomy (PNL) is increasing in light of technological developments. METHODSThis study included patients aged 16 years and below and who underwent PNL. The patients were divided into two groups: age 10 years and below and age 11-16 years. Routine hemogram, blood biochemistry, complete urine analysis, and urine culture were preoperatively evaluated. Patients with urinary tract infections underwent surgery following a sterile urine culture after antibiotherapy. The presence of urinary tract stone was preoperatively evaluated through direct urinary system radiography, urinary system ultrasonography, and intravenous pyelography (IVP). Considering the level of radiation, computed tomography was not planned unless absolutely necessary.The procedures of PNL were performed under general anesthesia. The bladders and urethral orifices of the patients were assessed in the supine position using 9-, 5-, 11-, or 13 Fr pediatric cystoscopes according to the age group. A 4-or 5 Fr urethral catheter was inserted with a C-arm fluoroscopy in the urethral orifice and fixed on a urethral Foley catheter. After this process, the patients were placed in a prone position, and the pelvicalyceal system was entered using a chiba needle with the guidance of fluoroscopy. The duration, amount, and number of radioactive dose were considered at minimal level during fluoroscopy. A lead material was placed on the testes or ovaries of the patients. Dilatation was provided up to 22 F via an Amplatz renal dilator set. Stones were broken with the help of a pediatric nephroscopy and pneumatic lithotripter. After the procedure, a nephrostomy (PNL) is a minimally invasive procedure that is safely performed for kidney stone surgery all over the world. In our clinic, PNL surgery was first performed in March 1998. In parallel with our increasing experience, PNL has been performed in pediatric cases. In our study, PNL operations performed in pediatric patients under the age of 10 years and in those over the age of 10 years were retrospectively investigated.Methods: Patients were between 0 and 16 years of age. They were divided into ...

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“…[10,[25][26][27][28][29][30] Firstly in 1985, Woodside et al [31] reported results of PNL procedures performed in pediatric patients. Success, and complication rates of PNL procedures resemble those in the adult patients.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive approaches and their efficacy in pediatric urolithiasis

Altıntaş

Beytur

Oğuz

et al. 2013

Turkish Journal of Urology

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Objective: We compared the frequency of usage and success of minimally invasive approaches in the management of pediatric urolithiasis in our clinic. Material and methods:Data from pediatric patients (≤16 years of age) who had undergone percutaneous nephrolithotomy (PNL), ureterorenoscopy (URS), and extracorporeal shock wave lithotripsy (ESWL) between January 2001 and December 2011 were retrospectively investigated. Results:In this study, 415 pediatric patients, who were treated for 291 renal, and 124 ureteral stones, were evaluated. The patients were treated with PNL (n=148; 82 boys, 66 girls), URS (n=99; 58 boys, and 41 girls) or ESWL (n=168; 91 boys, and 77 girls). The mean patient ages were 7.3 (1-16), 9.1 (1-16), and 8.8 (1-16) years in the PNL, URS, and ESWL groups, respectively. The stone-free rates after treatment with PNL, URS, and ESWL were 77, 83.8 and 88.7%, respectively. Conclusion:It is important that selected therapies are properly planned, and the use of minimally invasive approaches is important in pediatric patients due to potentially high recurrence rates. Currently, ESWL, PNL and URS are performed with high success rates for the treatment of stones, and open surgery is rarely used due to the success obtained with minimally invasive approaches.

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Percutaneous Stone Removal in Children

Cited by 200 publications

References 5 publications

Percutaneous nephrolithotomy in children before school age: experience of a Pakistani centre

Percutaneous nephrolithotomy in children before school age: experience of a Pakistani centre

Comparison of Percutaneous Nephrolithotomy Results in Pediatric Kidney Stone Disease in Patients Under the Age of 10 Years and in Patients Over the Age of 10 Years

Minimally invasive approaches and their efficacy in pediatric urolithiasis

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