Minipercutaneous Nephrolithotomy in the Management of Large and Complex Renal Calculi in Children: How Effective Is It?
J Endourol
; 37(4): 387-393, 2023 04.
Article
em En
| MEDLINE
| ID: mdl-36578212
ABSTRACT
Purpose:
To evaluate the efficacy and safety of minipercutaneous nephrolithotomy (PCNL) in the management of large and complex calculi in children. Patients andMethods:
From May 2017 to April 2021, a total of 41 pediatric cases were diagnosed with large/complex renal stones (partial-total staghorn) and following a detailed biochemical evaluation and thorough radiological examination (plain abdominal radiograph, urinary ultrasound, noncontrast and/or computed tomography), all cases underwent mini-PCNL procedure for the minimal invasive management of these calculi. Preoperative, intraoperative, and postoperative data were analyzed and reported in detail.Results:
A total of 41 procedures were performed in 26 boys and 15 girls (male/female = 1.73). While the age of the kids ranged from 2.5 to 10 years (mean 6.74 ± 2.76), mean size of the stones was 16.28 ± 3.43 mm (range 11-24) with a mean stone density value of 816 HU (range 550-1350). Evaluation of the success rates in terms of complete stone clearance on postoperative day 1 revealed that while 73.2% (30/41), residual fragments have been noted in 11 cases (26.8%). Size of the residual fragments ranged from 2 to 7 mm (mean 4.3). Of those children, 10 cases required flexible ureteroscopy for stone removal, and in 1 case, placement of Double-J was adequate for spontaneous passage. During a 3-month follow-up, the stone-free rate (SFR) increased to 100% without any residual fragment left.Conclusions:
Mini-PCNL with holmium laser lithotripsy is an effective and safe treatment alternative in the minimal invasive management of large/complex kidney stones in children with high SFRs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nefrostomia Percutânea
/
Litotripsia
/
Cálculos Renais
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Litotripsia a Laser
Limite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
J Endourol
Assunto da revista:
UROLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Kuait