Supine percutaneous nephrolithotomy in a 9-month infant

Vaddi, Chandra Mohan; Ramakrishna, Paidakula; Pm, Siddaliga Swamy; Anandan, Hemnath; Ganesan, Soundarya; Babu, Manas

doi:10.1016/j.eucr.2020.101424

Cited by 4 publications

(2 citation statements)

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“…[ 3 ] In addition, it has the effect of preventing the downward migration of stones to avoid a secondary ureteral extraction. However, there are several disadvantages to this operation; If the child has a twisted ureter or ureteral stenosis, it will lead to the failure of ureteral catheterization; The immune system of the child is not sound, and the high pressure of the retrograde saline infusion will easily lead to bacterial re-infiltration into the blood, increasing the incidence of postoperative infection [ 4 ] ; Retrograde infusion of saline or contrast agent will lead to extravasation of fluid or contrast agent, [ 5 ] which in turn can affect their imaging under ultrasound; The child’s position needs to be changed twice during the procedure, which prolongs the operation time and increases the risk of infection; and The anatomical features of the child are smaller, and the urethra and ureter are thinner and more curved than those of adults, which increases the risk of damaging the ureter and urethra, resulting in postoperative ureteral stricture. In order to avoid such risks, no ureteral catheter was left in place in the 3 children in this study, and all of them were successfully punctured in a single attempt, without reducing the success rate of the puncture or increasing the bleeding-related complications.…”

Section: Discussionmentioning

confidence: 99%

Total tubeless percutaneous nephrolithotomy without artificial hydronephrosis in preschool children: Three case reports

Zhang

et al. 2023

Medicine

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Rationale: Indwelling ureteral catheter, double J tube, or nephrostomy tube are routine procedures for percutaneous nephrolithotomy (PCNL) in children. There are a few cases in which PCNL has been performed in children without any additional instruments being left in place. Patient concerns: In this study, 3 children were treated for hematuria and complicated with different degrees of urinary tract infection. All of them were diagnosed as upper urinary tract calculi by abdominal computed tomography. Diagnosis: Three preschoolers were diagnosed with upper urinary tract calculi before surgery, one with no hydronephrosis and the other 2 with different degrees of hydronephrosis. Interventions: After preoperative evaluation, all the children successfully completed PCNL without indwelling ureteral catheter, double J tube, or nephrostomy tube. Outcomes: The operation was successful and there were no residual stones observed during postoperative review. The operating times for the children were 33 minutes, 17 minutes, and 20 minutes, and the intraoperative bleeding volumes were 1 mL, 2 mL, and 2 mL. The catheter was removed on the second day after the operation, the postoperative review of the abdominal computed tomography or ultrasound did not indicate any stone residue, and there were no fever, bleeding, and other related complications after the operation. Lessons: We believe that total tubeless PCNL without artificial hydronephrosis can be achieved in the preschool population.

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Section: Discussionmentioning

confidence: 99%

Total tubeless percutaneous nephrolithotomy without artificial hydronephrosis in preschool children: Three case reports

Zhang

et al. 2023

Medicine

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“…Microchannel percutaneous nephrolithotomy uses ultrasound guidance to observe the structure of the puncture channel in real time and distinguish the collection system, the renal calyx, and the location of kidney stones, which helps the physician grasp the position of the puncture needle, the puncture angle and the depth and avoid the puncture. This route prevents damage to the nearby pleura and spleen[ 11 - 15 ]. The establishment of an ideal percutaneous renal channel is an important factor for successful stone removal.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on the minimally invasive percutaneous nephrolithotomy treatment of upper urinary calculi

Xu¹,

Zhang²,

Li³

et al. 2022

WJCC

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BACKGROUND Upper urinary tract stones are very common in my country, with an incidence of 1% to 5% in the North and an even higher incidence of 5% to 10% in the south. The incidence rate in the south is higher than that in the north, mainly due to the water quality, climate and eating habits of the region. From the perspective of sex, incidence is more likely in males than females. In the high-incidence population, young adults are most prone to stones. Men in the age range of 25 to 40 years are more likely to have stones. AIM To observe the therapeutic effect of minimally invasive percutaneous nephrolithotomy (mPCNL) on upper urinary tract stones and its influence on the renal function of patients. METHODS Patients with upper urinary tract stones who were treated in our hospital from February 2017 to March 2018 were selected as research subjects and were divided into the PCNL group and the mPCNL group according to the random number table method. The general conditions of the two groups of patients were observed during the perioperative period, and the differences in stone clearance, pain, renal function indicators and complication rates were compared between the two groups to determine which were statistically significant ( P < 0.05). RESULTS The operation time of the mPCNL group was longer than that of the PCNL group ( t = -34.392, P < 0.001), and the intraoperative blood loss of the mPCNL group was more than that of the PCNL group ( t = 34.090, P < 0.001). There was no difference in renal function indices between the two groups of patients before treatment, and there was no difference in the levels of serum creatinine, β2 microglobulin or retinol binding protein in the mPCNL group after treatment. The visual analog scale score of patients in the mPCNL group was lower than that of the PCNL group ( t = 12.191, P < 0.001), and there was no significant difference in the stone clearance rate between the two groups ( χ 2 value = 1.013, P = 0.314). There was no significant difference in the incidence of urine extravasation, dyspnea and peripheral organ damage between the two groups ( χ 2 value = 1.053, P = 0.305). At 1 mo after treatment and 3 mo after treatment, the quality of life of the mPCNL group was lower than that of the PCNL group, and the Qmax level of the mPCNL group was higher than that of the PCNL group. CONCLUSION mPCNL has a good therapeutic effect on upper urinary tract stones, with a high stone clearance rate without causing kidney damage or increasing the incidence of complications, and thus has good application value.

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