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Percutaneous Nephrolithotomy in Paediatric Population: A Single Center Experience
Mahesh Bahadur Adhikari1, Sumeet Karna1, Kinju Adhikari1
1Department of Urology, B and B Hospital, Gwarko, Lalitpur, Nepal.
Journal of Nepal Health Research Council
|September 24, 2020
Summary
Percutaneous nephrolithotomy (PCNL) is a safe and effective minimally invasive procedure for managing paediatric stone disease. This study found PCNL achieved a high stone-free rate with acceptable complications in children.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Nephrolithiasis Management
Background:
- Paediatric stone disease presents unique management challenges due to higher risk.
- Percutaneous nephrolithotomy (PCNL) offers advantages in stone clearance and renal function preservation.
Purpose of the Study:
- To evaluate the safety and efficacy of PCNL in paediatric patients.
- To assess stone clearance rates and complication profiles of PCNL in children.
Main Methods:
- Retrospective study of 44 paediatric patients (up to 18 years) undergoing PCNL from 2010-2018.
- Data collected included demographics, operative details, stone characteristics (Guy's stone score), and post-operative outcomes (hemoglobin drop, complications).
- Different PCNL techniques (standard, mini, supermini) were analyzed.
Main Results:
- 48 renal units treated with PCNL, achieving a 93.4% stone-free rate.
- Mean stone size was 17.16 mm; 91.6% had low Guy's stone score (1-2).
- Overall complication rate was 18.1%, with most being low-grade (Clavien-Dindo Grade 1-2).
Conclusions:
- PCNL is a safe and feasible option for paediatric patients with significant stone burden or complex cases.
- The procedure demonstrates acceptable stone-free and complication rates in the paediatric population.
- PCNL is a viable alternative for cases refractory to extracorporeal shockwave lithotripsy.
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