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Related Experiment Videos

Percutaneous nephrolithotomy in the pediatric population.

A M Al-Shammari1, K Al-Otaibi, M P Leonard

  • 1Division of Pediatric Urology, Children's Hospital, Health Sciences Centre, University of Manitoba, Winnipeg, Canada.

The Journal of Urology
|October 19, 1999
PubMed
Summary

Percutaneous nephrolithotomy is a safe and effective treatment for pediatric kidney stones, achieving an 87.5% stone-free rate. Staghorn calculi may require alternative management, especially with anatomical abnormalities.

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Area of Science:

  • Pediatric Urology
  • Nephrolithiasis Management
  • Minimally Invasive Surgery

Background:

  • Renal calculi (kidney stones) are a significant concern in pediatric patients.
  • Percutaneous nephrolithotomy (PCNL) is an established minimally invasive surgical technique.
  • Evaluating the efficacy and safety of PCNL in children is crucial for treatment guidelines.

Purpose of the Study:

  • To review the experience with percutaneous nephrolithotomy (PCNL) for treating nephrolithiasis in children.
  • To assess the safety and effectiveness of PCNL as a primary treatment for pediatric kidney stones.
  • To identify factors influencing PCNL outcomes in the pediatric population.

Main Methods:

  • Retrospective review of pediatric patients undergoing PCNL from 1985 to 1996.

Related Experiment Videos

  • Standardized antegrade percutaneous access and tract dilation to 24F.
  • Utilized various lithotripsy methods (ultrasound, electrohydraulic) and grasper forceps for stone removal.
  • Postoperative assessment included X-rays, nephrostograms, and long-term follow-up with imaging and metabolic evaluation.

    • Main Results:

    • Ten PCNL procedures were performed on 9 pediatric renal units (5 boys, 3 girls, ages 4-11).
    • An 87.5% stone-free rate was achieved with PCNL monotherapy.
    • Complications included hypothermia in 2 cases with prolonged operative time (>150 min); no blood transfusions were needed.
    • PCNL was unsuccessful for a staghorn calculus in one patient with associated anatomical abnormalities.

    Conclusions:

    • Percutaneous nephrolithotomy (PCNL) is a safe and effective option for pediatric renal calculi.
    • Staghorn calculi, particularly with underlying anatomical issues, may necessitate alternative treatment strategies.
    • Comprehensive anatomical and metabolic assessment is recommended for all children with kidney stones, alongside appropriate medical therapy.