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Upper pole access is safe and effective for pediatric percutaneous nephrolithotomy
Sedat Oner1, Ahsen Karagozlu Akgul2, Murat Demirbas1
1Department of Urology, University of Medical Science, Bursa Yüksek İhtisas Education and Research Hospital, Bursa, Turkey.
Journal of Pediatric Urology
|February 21, 2018
Summary
Single upper pole access in pediatric percutaneous nephrolithotomy (PCNL) is safe and effective. This approach offers comparable outcomes to other access points without serious complications, making it a viable alternative for pediatric kidney stone removal.
Area of Science:
- Urology
- Pediatric Surgery
- Nephrolithotomy
Background:
- Upper pole access in percutaneous nephrolithotomy (PCNL) offers advantages like a straight tract and better exposure.
- However, it's often avoided in pediatric patients due to concerns about chest complications.
Purpose of the Study:
- To evaluate the safety and morbidity of single upper pole access in pediatric patients undergoing PCNL.
- To compare outcomes between single upper pole access and other single pole accesses.
Main Methods:
- Retrospective review of pediatric patients (≤17 years) who underwent PCNL with single access.
- Comparison of demographic features, stone characteristics, operative data, and outcomes between the single upper pole access group (SUPAG) and single other pole access group (SOPAG).
- Complications were classified using the modified Clavien system.
Main Results:
- No statistically significant differences in demographics or stone burden between SUPAG (10 patients) and SOPAG (67 patients).
- Operative parameters were similar; median operation time was shorter in SUPAG (37 min) vs. SOPAG (45 min).
- SUPAG had no chest complications or bleeding requiring transfusion, and achieved a 100% stone-free rate, compared to 82.1% in SOPAG.
Conclusions:
- Single upper pole access in pediatric PCNL is safe and effective.
- It yields outcomes comparable to other access points with minimal serious complications.
- This approach is a good alternative for pediatric kidney stone removal.
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