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Karkin K, Aydamirov M, Aksay B, Kaplan E, Gürlen G, Altunkol A, Ortaoğlu F, Akgün ÖF, Vuruşkan E, Gürbüz ZG. Comparison of two percutaneous nephrolithotomy methods for the treatment of pediatric kidney stones: mini-percutaneous nephrolithotomy and standard percutaneous nephrolithotomy. Arch Ital Urol Androl 2024; 96:12369. [PMID: 38713072 DOI: 10.4081/aiua.2024.12369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/17/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVE In this study, the aim was to compare the results of mini and standard percutaneous nephrolithotomy (PCNL) for the treatment of pediatric kidney stones. MATERIALS AND METHODS Data for 128 patients < 18 years of age who underwent mini and standard PCNL due to pediatric kidney stones were retrospectively examined. Patients were divided into two groups: mini-PCNL (16-20 Fr) and standard PCNL (26 Fr). Surgery time, number of punctures to the pelvicalyceal system, hospital stay, postoperative hemoglobin drop, complications and stone-free status (SFR) were compared between the groups. Additional surgical intervention (double-J stent, ureterorenoscopy, secondary PCNL) performed after the surgery was recorded. The absence of residual stones or < 3 mm residual stones on kidney, ureter and bladder radiography (KUB) and ultrasonography (USG) performed in the third postoperative month were accepted as success criteria. RESULTS There were 32 (43.8%) patients in the mini-PCNL group and 41 (56.2%) patients in the standard PCNL group. The mean age was 9.3 ± 4.1 years in the mini-PCNL group and 10.1 ± 5.4 years in the standard PCNL group. Mean stone size in the mini-PCNL group was 2.1 ± 1.2; while for standard PCNL it was 2.3 ± 1.4. The mean surgery time was statistically significantly higher in the mini-PCNL group (p = 0.005). There was no difference between the groups in terms of intraoperative double J stent use, postoperative complications and SFR. A double J stent was inserted in two patients in the mini-PCNL group and in one patient in the standard PCNL group due to urine leakage from the nephrostomy tract in the postoperative period. Although the postoperative hemoglobin drop was found to be significantly higher in standard PCNL (p = 0.001), hematuria and blood transfusion rates were low in both groups. Mean hospital stay was shorter in the mini-PCNL group compared to standard PCNL (3.6 ± 1.2 days vs. 2.5 ± 1.1; p = 0.018). CONCLUSIONS Although mini-PCNL has longer surgery time compared to standard PCNL, it should be preferred for the treatment of pediatric kidney stones due to advantages such as similar success and complication rates to standard PCNL, short hospital stay and less postoperative hemoglobin drop.
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Affiliation(s)
- Kadir Karkin
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Mubariz Aydamirov
- Bas¸kent University, Alanya Application and Research Center, Alanya.
| | - Buğra Aksay
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Eyüp Kaplan
- Abdulkadir Yüksel State Hospital Urology Clinic, Gaziantep.
| | - Güçlü Gürlen
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Adem Altunkol
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Ferhat Ortaoğlu
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Ömer Faruk Akgün
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Ediz Vuruşkan
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
| | - Zafer Gökhan Gürbüz
- Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana.
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Adanur S, Demirdogen SO, Aksakalli T, Cinislioglu AE, Utlu A, Al S, Akkas F, Altay MS, Polat O. Outcomes of ultraminipercutaneous nephrolithotomy in infants: our experiences at a single center in an endemic region. Pediatr Surg Int 2024; 40:48. [PMID: 38300307 DOI: 10.1007/s00383-023-05623-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVE In this study, we aimed to contribute to the literature by sharing the perioperative and postoperative outcomes of infants (0-24 months) who underwent ultra-mini percutaneous nephrolithotomy (PNL) for kidney stones in our clinic. METHODS Infants under 24 months old with kidney stones of 2 cm and larger, who applied to our clinic between January 2018 and May 2023, were included in the study. The patients' demographic and clinical characteristics were obtained from the medical records. The collected data were analyzed retrospectively. RESULTS A total of 26 patients were included in the study. The mean age of the patients was 17.3 ± 3.90 (12-24) months. The mean operation time was 50.7 ± 6.43 min. The mean stone size was 2.66 ± 0.59 cm. Stone-free was achieved in 23 patients (88.5%). In one patient (3.8%) with residual fragments, SWL was performed, and in two patients (7.7%), RIRS was performed to achieve stone-free. Postoperatively, fever was observed in 3 patients (11.5%). There were no patients requiring blood transfusion. CONCLUSIONS In experienced centers, ultra-mini-PNL performed by experienced surgeons is an effective and reliable treatment option for infants under 24 months of age with kidney stones larger than 2 cm. It provides high-stone clearance rates and low complication rates.
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Affiliation(s)
| | | | - Tugay Aksakalli
- Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | | | - Adem Utlu
- Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Salih Al
- Atatürk University, Erzurum, Turkey
| | - Fatih Akkas
- Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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Kumar N, Yadav P, Kaushik VN, Kakoti S, Chakraborty A, Kumar D, Ansari MS. Mini-versus standard percutaneous nephrolithotomy in pediatric population: A randomized controlled trial. J Pediatr Urol 2023; 19:688-695. [PMID: 37661501 DOI: 10.1016/j.jpurol.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/07/2023] [Accepted: 08/12/2023] [Indexed: 09/05/2023]
Abstract
INTRODUCTION Mini PCNL has gained popularity in adult patients due to reduction in the complication rate with comparable stone free rate. There is paucity of level 1 evidence regarding the benefit of mini PCNL in the pediatric group. OBJECTIVE We performed a randomised study to compare mini PCNL (mPCNL) with standard PCNL (sPCNL) for the management of renal calculi in patients less than 18 years of age in terms of safety, efficacy, and stone-free rate (SFR). MATERIALS AND METHODS A randomised controlled trial was performed on 50 children who underwent PCNL from June 2015 to March 2021, who were divided into two groups. Group I had 25 patients managed with mPCNL (sheath size 16.5 Fr) and Group II had 25 patients who underwent sPCNL (sheath size 26 Fr). Primary outcomes including stone free rates (SFR) and hemoglobin drop and secondary outcomes like operative time, complications, pain score, need of analgesia, incidence of nephrostomy site leak, hospital stay in days were compared between the two groups. RESULTS The mean age of patients in groups I and II was 9.4 ± 2.6 and 10.4 ± 2.26 years, respectively (p = 0.15). The mean stone sizes in both groups I and II were 18.6 ± 2.56 and 20.2 ± 3.58 mm, respectively (p > 0.05). The stone free rate for group I was 88% and for group II, 92% (p = 0.64). The average drop in hemoglobin was higher in group II compared to group I (1.1 ± 0.31 g/dl and 1.7 ± 0.23 g/dl respectively; p < 0.0001), however the mean blood transfusion rate was not significantly different in both groups. The operating time was shorter in group II compared to group I (p-value - 0.0030). The pain scores were lesser for the group I. Grade I complications were higher in group II as compared to group I (p-0.047); however, grade II complications were comparable in both groups. The mean hospital stay was not significantly different in both groups. DISCUSSION This study confirms the role of mini PCNL in pediatric patients with renal stones. The stone clearance rate of mini PCNL is equivalent to standard PCNL, with lesser blood loss and postoperative complications, however with longer operative time during mPCNL. The small number of the participants in both arms is a limitation of this study and may also reflect fewer children with urolithiasis being treated surgically even in a tertiary care referral centre. CONCLUSIONS Mini-PCNL offers equivalent stone free outcome with lower complications rate compared to the standard PCNL for all types of renal stones.
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Affiliation(s)
- Naveen Kumar
- Department of Urology, All India Institute of Medical Sciences, Patna, 801507, Bihar, India.
| | - Priyank Yadav
- Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - Vinay N Kaushik
- Department of Urology, BGS Global Institute of Medical Sciences, Bangalore South, 560060 Karnataka, India.
| | - Shitangsu Kakoti
- Department of Urology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India.
| | - Anwesa Chakraborty
- Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - Dinesh Kumar
- Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
| | - M S Ansari
- Division of Pediatric Urology, Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
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Önal B, Kırlı EA. Pediatric stone disease: Current management and future concepts. Turk Arch Pediatr 2021; 56:99-107. [PMID: 34286317 DOI: 10.5152/turkarchpediatr.2021.20273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/27/2020] [Indexed: 12/30/2022]
Abstract
Treatment of pediatric urolithiasis consists of medical and surgical approaches. The main goal of the treatment is to prevent stone recurrence by avoiding multiple surgical interventions. In recent years, many innovations have been reported in the medical diagnostic evaluation protocol and in surgical treatment. According to recent reports, single mutations could be responsible for a larger proportion of renal stones. This etiologic feature holds the potential to change the management in stone prevention from metabolically directed therapy to more specific approaches. In addition, miniaturized instruments have been adopted in clinical practice. In recent years, minimally invasive endoscopic surgery is the treatment of choice in pediatric urolithiasis. This review aims to assess the current literature on medical and surgical treatment options for pediatric urolithiasis. We also aim to provide an overview of potential future advances.
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Affiliation(s)
- Bülent Önal
- Department of Urology, İstanbul University-Cerrahpaşa, Cerahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Elif Altınay Kırlı
- Department of Urology, İstanbul University-Cerrahpaşa, Cerahpaşa Faculty of Medicine, İstanbul, Turkey
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Izol V, Satar N, Bayazit Y, Gokalp F, Akdogan N, Aridogan IA. Which factors affect the success of pediatric PCNL? Single center experience over 20 years. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348964 DOI: 10.4081/aiua.2020.4.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/30/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We aimed to investigate the impact of surgeons' experience on pediatric percutaneous nephrolithotomy (PCNL) outcomes. MATERIALS AND METHODS Between June 1997 and June 2018, 573 pediatric patients with 654 renal units underwent PCNL for renal stone disease by senior surgeons. Data were divided into two groups, group-1 (n = 267), first ten years period, group-2 (n = 387); second ten years period. RESULTS Mean ± SD age of patients was 7.6 ± 4.9 (1-17) years. The stone-free rates (SFR) assessed after 4 weeks were 74.9% vs. 83.4% in group-1 vs. group-2, respectively (p = 0.03). The mean operation time, fluoroscopy time, and the number of patients requiring blood transfusion significantly decreased in group 2 (100.4 ± 57.5 vs. 63.63 ± 36.3, 12.1 ± 8.3 vs. 8.3 ± 5.4, and 24.3% vs. 2.9%; p < 0.001, p < 0.001, and p = 0.002 in group-1 versus group-2, respectively). On multivariate analysis, increasing stone size increased operation time (p < 0.001), fluoroscopy time (p < 0.001), intraoperative and postoperative blood transfusion rates (p = 0.006 and p = 0.018, respectively), and hospital stay (p = 0.002) but was not associated with change of glomerular filtration rate (GFR) (p = 0.71). Sheath size also correlated with increased fluoroscopy time (p < 0.001), operation time (p < 0.001), intraoperative blood transfusion (p < 0.001) and hospital stay, but sheath size did not affect postoperative blood transfusion (p = 0.614) or GFR change (p = 0.994). CONCLUSIONS The percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure and is well accepted because of its lower complication rate and high efficiency for pediatric patients. Stone and sheath size are predictive factors for blood loss and hospital stay. During 20 years, our fluoroscopy time, operation time, blood loss, and complication rates decreased, and stone-free rate increased.
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Affiliation(s)
- Volkan Izol
- Department of Urology, Faculty of Medicine, University of Çukurova, Adana.
| | - Nihat Satar
- Department of Urology, Faculty of Medicine, University of Çukurova, Adana.
| | - Yıldırım Bayazit
- Department of Urology, Faculty of Medicine, University of Çukurova, Adana.
| | - Fatih Gokalp
- Clinic of Urology, Osmaniye Government Hospital, Osmaniye.
| | - Nebil Akdogan
- Department of Urology, Faculty of Medicine, University of Çukurova, Adana.
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Xiao B, Diao X, Jin S, Ji C, Zhang G, Su B, Tang Y, Li J. A Novel Surgical Technique for Treatment of Renal Stones in Preschool-aged Patients: Initial Experience With Needle-perc. Urology 2020; 146:211-215. [PMID: 32791292 DOI: 10.1016/j.urology.2020.07.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe and evaluate our newly developed minimal instrumentation technique, needle-perc, for treatment of preschool-aged patients with renal stones. To the best of our knowledge, this is the smallest endoscopic equipment for percutaneous nephrolithotomy reported thus far. MATERIALS AND METHODS Needle-perc was performed in 8 patients using a 4.2-Fr needle to achieve access to the collecting system under ultrasonic guidance alone. The mean patient age was 2.4 years (range, 0-5 years). Five of the 8 patients were boys, while 3 were girls. Six patients had unilateral stones and 2 patients had bilateral stones. Six renal units exhibited single calculus, 2 exhibited staghorn stones, and 2 exhibited multiple stones. The mean calculus size was 1.6 cm (range, 0.8-4.5 cm). Preoperative, intraoperative, and postoperative parameters were analyzed prospectively. RESULTS Access was successfully achieved in all patients. Puncturing was fully guided by ultrasound. Five patients underwent needle-perc alone. Two patients were transferred to 16-Fr access because of intrarenal infection and large stone burden. One patient underwent reduction of tract number. The mean operative time was 49.2 minutes (range, 22-75 minutes); mean hemoglobin loss was 5.2 g/L (range, 0-13.8 g/L). The mean postoperative hospital stay was 5 days (range, 3-7 days). Preplaced catheters were kept for 2-3 days to facilitate fragment discharge. Complications occurred in 2 patients: fever >38.5°C. The stone-free rate was 100% at 1 month postoperatively. CONCLUSION Our initial data indicate that needle-perc is feasible and safe for preschool-aged renal patients. Further studies are required to define its usefulness in treatment of larger stones.
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Affiliation(s)
- Bo Xiao
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China
| | - Xiaolin Diao
- Department of Medicine, Peking University Hospital, Beijing, China
| | - Song Jin
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China
| | - Chaoyue Ji
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China
| | - Gang Zhang
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China
| | - Boxing Su
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China
| | - Yuzhe Tang
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China
| | - Jianxing Li
- Department of Urology, Beijing Tsinghua Changgung Hospital Affiliated With Tsinghua University, Tsinghua University Clinical Institute, Beijing, China.
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Mahmood SN, Aziz BO, Tawfeeq HM, Fakhralddin SS. Mini- versus standard percutaneous nephrolithotomy for treatment of pediatric renal stones: is smaller enough? J Pediatr Urol 2019; 15:664.e1-664.e6. [PMID: 31604603 DOI: 10.1016/j.jpurol.2019.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/07/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Miniaturized percutaneous nephrolithotomy (PCNL) has gained increased popularity owing to efforts in recent years to lower peri-operative morbidity while maintaining a high stone-free rate (SFR). OBJECTIVE The outcomes of pediatric renal stones treated by mini-PCNL (MPCNL) versus standard PCNL (SPCNL) were retrospectively assessed. STUDY DESIGN A retrospective data analysis of 134 consecutive patients younger than 17 years who underwent PCNL between January 2014 and July 2018 was performed. The patients were categorized into two treatment groups depending on the tract size and instruments used. Seventy-five patients were treated by SPCNL using adult instruments via a 22-26 Fr tract, and 59 patients were treated by MPCNL using pediatric instruments via a 16-20 Fr tract. RESULTS A total of 134 children (SPCNL = 75; MPCNL = 59) underwent PCNL and subsequent evaluation. Patient demographics and stone characteristics were comparable between the two groups. The mean stone size ranged from 1.9 ± 1.162 cm in the MPCNL group to 2.2 ± 1.424 cm in the SPCNL group, and the overall SFR was 89.5% in the MPCNL group and 94.7% in the SPCNL group. When comparing the common characteristics, no significant difference was found between the two surgical access regarding the mean operative duration, SFR, incidence of peri-operative complications, and the rate of bleeding requiring a blood transfusion. Conversely, the mean postoperative hemoglobin decrease was significantly lower in the MPCNL group relative to the SPCNL group, at 0.354 ± 0.299 g versus 0.568 ± 0.332 g, respectively (P = 0.001). In addition, the mean duration of hospitalization was significantly lower in the MPCNL group than in the SPCNL group, at 1.91 ± 1.154 days compared with 2.41 ± 1.14 days, respectively (P = 0.014). DISCUSSION Herein, the authors report the first systematic review of the first center in the locality treating this cross section of patients. This review reveals that the use of these smaller instruments can deliver a strong safety profile while achieving good stone clearance. As an alternative to decreasing the peri-operative morbidity associated with SPCNL, MPCNL can be conveniently used without affecting the outcomes of the procedure. It is a safe and feasible procedure for maximal clearance of stones and should comprise the treatment of choice-regardless of age-for experienced endourologists. CONCLUSION MPCNL represents a valuable way of treating simple and complex renal stones in children, with an operative time, SFR, and overall complication rate comparable with those of SPCNL. Mini-PCNL resulted in shorter hospitalization and fewer hemoglobin drops.
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Affiliation(s)
- Sarwar Noori Mahmood
- University of Sulaymania, College of Medicine, Department of Surgery, Sulaymania 46001, Iraq.
| | - Bryar Othman Aziz
- Sulaymania General Teaching Hospital, Urology Department, Sulaymania 46001, Iraq
| | - Hewa Mahmood Tawfeeq
- Sulaymania General Teaching Hospital, Urology Department, Sulaymania 46001, Iraq
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Silay MS, Ellison JS, Tailly T, Caione P. Update on Urinary Stones in Children: Current and Future Concepts in Surgical Treatment and Shockwave Lithotripsy. Eur Urol Focus 2017; 3:164-171. [DOI: 10.1016/j.euf.2017.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/06/2017] [Accepted: 07/18/2017] [Indexed: 01/04/2023]
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Celik H, Camtosun A, Altintas R, Tasdemir C. Percutaneous nephrolithotomy in children with pediatric and adult-sized instruments. J Pediatr Urol 2016; 12:399.e1-399.e5. [PMID: 27473257 DOI: 10.1016/j.jpurol.2016.04.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/27/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Pediatric stone disease is a significant health issue which has increased in incidence because of lifestyle changes, dietary habits, and obesity. The incidence of urolithiasis among pediatric age groups varies according to region and is high in Turkey. The management of stone disease in children has improved dramatically over the last two decades. The high success rate of percutaneous nephrolithotomy (PNL) have led modern researchers to suggest that it be used as a first-line treatment of kidney stones greater than 2 cm in size. This study compared the outcomes, including morbidity and success rates, of different groups of pediatric patients who underwent PNL via pediatric- and adult-sized instruments. METHODS Percutaneous nephrolithotomy was performed in 194 children in a clinical setting between the years 2000 and 2015. Patients were categorized into 2 groups (group 1: pediatric-sized devices used, n = 90 [46.4%]; group 2: adult-sized devices used, n = 104 [53.6%]). The children in group 2 were further divided into subgroups: a 24 F nephroscope was used for group 2a (n = 84 [43.3%]) and a 26 F nephroscope was used for group 2b (n = 20 [10.3%]) (Figure). RESULTS For this study, a total of 194 pediatric patients (99 boys and 95 girls ranging from 8 months to 17 years of age, with a mean age of 9.43 years) underwent PNL for the removal of kidney stones in a clinical setting. Between the examined groups, there were no significant differences in patient height or weight, stone site or localization, pre- and post-operative creatinine levels, duration of nephrostomy, or hospitalization time. There was also no significant variation in minor complications such as fever or urinary infection. However, the stone burden was notably smaller in the group wherein pediatric-sized nephroscopes were used. Additionally, the incidence of hemorrhage was markedly lower in groups where a 17 F nephroscope was used than in groups where treatment was administered via 24 and 26 F nephroscopes. CONCLUSIONS Stone disease is considered to be relatively rare in childhood, but recent studies have indicated that it presents a considerable health problem. According to some researchers, a decrease in instrument size has not meaningfully reduced complication rates. In contrast, some studies have reported that the use of smaller sized nephroscopes may reduce rates of morbidity and mortality. In this study, success rates of PNL were similar across all groups, regardless of nephroscope size. However, the use of a 17 F nephroscope significantly decreased the rate of hematocrit level reduction (p < 0.001). While instrument size does not affect the success of PNL, smaller instruments can be used to reduce various complications such as bleeding.
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Affiliation(s)
- Huseyin Celik
- Inonu University School of Medicine, Department of Urology, Malatya, Turkey.
| | - Ahmet Camtosun
- Inonu University School of Medicine, Department of Urology, Malatya, Turkey
| | - Ramazan Altintas
- Inonu University School of Medicine, Department of Urology, Malatya, Turkey
| | - Cemal Tasdemir
- Inonu University School of Medicine, Department of Urology, Malatya, Turkey
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Celik H, Camtosun A, Dede O, Dagguli M, Altintas R, Tasdemir C. Comparison of the results of pediatric percutaneous nephrolithotomy with different sized instruments. Urolithiasis 2016; 45:203-208. [DOI: 10.1007/s00240-016-0887-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/27/2016] [Indexed: 11/30/2022]
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Dağgülli M, Sancaktutar AA, Dede O, Utanğaç MM, Bodakçi MN, Penbegül N, Hatipoğlu NK, Çakmakçı S. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience. Urolithiasis 2015; 43:507-12. [DOI: 10.1007/s00240-015-0787-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 05/12/2015] [Indexed: 10/23/2022]
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