Percutaneous nephrolithotomy in children

Introduction The high success rates of percutaneous nephrolithotomy (PCNL) in the clearance of large renal calculi has made it a primary mode of surgical management in adults. Similarly, in children too PCNL has been gaining ground and the indications for the same are on the rise. We retrospectively...

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Bibliographic Details
Published in:Pediatric surgery international 2021-08, Vol.37 (8), p.1109-1115
Main Authors: Nerli, R. B., Ghagane, Shridhar C., Mungarwadi, Amit, Patil, Shivagouda
Format: Article
Language:English
Subjects:
Blood transfusions
Catheters
Children & youth
Kidney stones
Lithotripsy
Medicine
Medicine & Public Health
Morbidity
Original Article
Patients
Pediatric Surgery
Pediatrics
Surgery
Ultrasonic imaging
Urology
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Summary:Introduction The high success rates of percutaneous nephrolithotomy (PCNL) in the clearance of large renal calculi has made it a primary mode of surgical management in adults. Similarly, in children too PCNL has been gaining ground and the indications for the same are on the rise. We retrospectively evaluated the safety and efficacy of this technique, in children below 18 years of age. Materials and methods We retrospectively reviewed the inpatient, outpatient records, imaging films of all children with renal stones undergoing PCNL at our hospital. Results During the study period, 123 children underwent 129 PCNL at our centre for renal calculi. The mean age was 11.06 years and 87 (70.73%) of the children were males. The size of the stones varied from 15 to 37 mms in the longest diameter. A complete staghorn was noted in six (4.65%) and a partial staghorn in nine (6.97%) children. Supine PCNL was performed in 21 (16.2%) children and remaining 102 (83.7%) children underwent PCNL in prone position. The mean drop in haemoglobin was 1.24 gm%. Stone clearance was achieved in 122 (94.5%) children. Post-operatively four (3.1%) children needed blood transfusions due to excessive bleeding. Conclusions Refinements in percutaneous access techniques, miniaturization of instruments, and technologic advances in energy sources for lithotripsy have led to improvement of outcomes and have lowered the morbidity rates in children following PCNL. It is a safe and effective means of clearing large volumes of renal calculi with minimal morbidity.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-021-04901-6