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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
Published on: June 21, 2024
Percutaneous nephrolithotomy in pediatric patients: is computerized tomography a must?
Abdullah Gedik1, Ali Tutus, Devrim Kayan
1Department of Urology, Medical School, Dicle University, 21280, Diyarbakir, Turkey. abgedik@gmail.com
Urological Research
|April 17, 2010
Summary
Percutaneous nephrolithotomy (PNL) is effective for pediatric kidney stones. Non-contrast computerized tomography (CT) is crucial before PNL to prevent complications like colon perforation.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
Background:
- Kidney stones in children present unique challenges.
- Percutaneous nephrolithotomy (PNL) is a common treatment option.
- Pre-operative imaging is essential for safe and effective PNL.
Purpose of the Study:
- To retrospectively evaluate pediatric percutaneous nephrolithotomy (PNL) outcomes.
- To assess the necessity and impact of non-contrast computerized tomography (CT) in pediatric PNL.
- To identify factors influencing stone-free rates and complications.
Main Methods:
- Retrospective analysis of 48 pediatric patients undergoing PNL.
- Review of pre-operative imaging (intravenous urography or CT).
- Evaluation of PNL operative time, fluoroscopy time, stone burden, and complications.
Main Results:
- PNL demonstrated a high stone-free rate (34/45 patients).
- Complications included two conversions to open surgery and two instances of urine extravasation requiring double J stents.
- Non-contrast CT identified a retrorenal colon in one case, preventing potential transcolonic access during PNL.
Conclusions:
- PNL is a safe and effective treatment for pediatric kidney stones.
- Pre-operative non-contrast CT is vital to prevent iatrogenic complications, particularly colon perforation.
- Surgical experience significantly impacts achieving stone-free outcomes.
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