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Safety and Efficacy of Percutaneous Nephrolithotomy in Children
Udaya Man Singh Dongol1, Yugal Limbu1
1Department of Urosurgery, Kathmandu Medical College and Teaching Hospital, Kathmandu.
Insights
Percutaneous nephrolithotomy (PCNL) is a safe and effective treatment for pediatric renal stones, achieving an 88% stone-free rate. This minimally invasive procedure demonstrated minimal complications in children with average 2 cm kidney stones.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Management
- Minimally Invasive Surgery
Background:
- Renal stone disease affects 5-15% of children, with predisposing factors including anatomical abnormalities, UTIs, metabolic issues, and environmental influences.
- Percutaneous nephrolithotomy (PCNL) is evaluated for pediatric application in managing kidney stones.
Purpose of the Study:
- To assess the safety and efficacy of percutaneous nephrolithotomy (PCNL) in pediatric patients with renal stone disease.
Main Methods:
- A study involving 25 children with renal stones who underwent percutaneous nephrolithotomy between May 2012 and December 2016.
- Evaluation focused on stone-free rates, complication incidence, need for blood transfusions, and secondary treatments.
Main Results:
- The average patient age was 9.3 years, with stones averaging 2 cm in size.
- An 88% stone-free rate was achieved before discharge; 3 patients required blood transfusions.
- Complications included fever, hematuria, ileus, and urine leak, with no major adverse events reported.
Conclusions:
- Percutaneous nephrolithotomy (PCNL) is a safe, effective, and feasible treatment option for children with renal stones up to 2 cm.
- The procedure showed no significant impact on hemoglobin or creatinine levels post-surgery.
Background:
Renal stone disease is a common problem in children in developing countries. Its prevalence in children varies from 5% to 15%. It is suggested that anatomic abnormalities, recurrent urinary tract infections, metabolic disturbances, dietary and environmental factors are the predisposing factors.The aim of this study is to evaluate the safety and efficacy of percutaneous nephrolithotomy in children.
Methods:
Between May 2012 and Dec 2016, 25 children with renal stone diseases underwent percutaneous nephrolithotomy and were evaluated for stone free rate, complications, blood transfusion rate, sandwich therapy, etc.
Results:
The mean age of children was 9.3 years (7-15 years) and the mean size of the stone was 20 mm (13-27 mm). The anatomical location of stone was important in terms of stone clearance. Three patients needed blood transfusion. The overall stone free rate was 88% before discharge. Three patients had residual stones and were treated with extracorporeal shockwave lithotripsy. Complications included fever, haematuria, ileus and urine leak. No major complications were noted. There were no significant differences in haemoglobin and creatinine levels before and 12 hours after the surgery.
Conclusions:
Percutaneous nephrolithotomy (PCNL) can be considered a safe, effective and feasible modality of treatment for children with an average of 2 cm sized renal stones.
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