Percutaneous treatment of stones in pediatrics: A retrospective multicenter study |
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| Institution: | 4. Hacettepe University School of Medicine, Department of Urology Division of Paediatric Urology, Ankara, Turkey;1. Hacettepe University School of Medicine, Department of Urology, Ankara, Turkey;2. Cukurova University School of Medicine, Department of Urology, Adana, Turkey;3. Ondokuz Mayis University School of Medicine, Department of Urology, Samsun, Turkey;1. Department of Pediatric Surgery, Faculty of Medicine of Porto, Hospital S. João, 4200-319 Porto, Portugal;2. Department of Pediatric Surgery, Hôpital Lenval, Nice, France;3. Department of Pediatrics, Pediatric Surgery, “Frederico II” University of Naples, School of Medicine, Naples, Italy;1. Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan;2. Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;3. Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;4. Department of Anatomy, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;1. Department of Urology, University of Texas Southwestern Medical Center, Children''s Medical Center, 2350 Stemmons Freeway #D-4300, Dallas, TX 75235, USA;2. Department of Pediatrics, Division of Pediatric Hematology-Oncology, University of Texas Southwestern Medical Center, Children''s Medical Center, 1935 Motor Street, Dallas, TX 75235, USA;1. Unité pédiatrique de Médecine Physique et Réadaptation – Groupe Hospitalier Universitaire Trousseau – La Roche Guyon, Université Pierre et Marie Curie, Paris, France;2. Service de chirurgie viscérale pédiatrique Groupe Hospitalier Universitaire Trousseau – La Roche Guyon, Université Pierre et Marie Curie, Paris, France |
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| Abstract: | PurposeThis study was conducted to investigate the cons and pros of percutaneous stone treatment in a large population of children in a retrospective manner.Material and methodsThree centers with experience in pediatric stone disease were included in this study. The data regarding the patients, stones, surgery and postoperative course were collected from each center.Results346 renal units were operated in 311 (M:211, F:100) pediatric patients. The ages ranged from 9 months to 16 year old (mean:8.6). The mean stone area was 338.7 mm2 (25-2075). Five had horseshoe kidneys, 2 had stones in caliceal diverticula, 9 had solitary kidney and 5 children had chronic renal failure. The procedure was carried out using different sizes of instruments within a mean surgery time of 90 min (10-270) and a mean fluoroscopy time of 12.9 min. (1.5-53). 267 (77%) renal units were rendered completely stonefree without major complications. The mean hospitalization time was 5.1 days (2-31). Blood transfusion rate was 14.7%, re-PCNL was performed in 8, adjuvant SWL was done in 6. Two had nonfunctional kidneys on follow-up.ConclusionsPercutaneous nephrolithotomy is a standard treatment option for most of the large stones in pediatrics with acceptable morbidity. The technique is well established and is no longer of concern for this age group. Future studies should focus on randomized comparative trials with SWL. |
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