MP33-08 PREDICTING FACTORS FOR COMPLICATIONS AND STONE CLEARANCE FOLLOWING PEDIATRIC MINI-PERCUTANEOUS NEPHROLITHOTOMY
| Autor: | Hany A. Morsi, Waseem Aboulela, Hesham Badawy, Ahmed M. Shouman, Ahmed I. Shoukry, Mohammed S. ElSheemy, Kareem Daw, Mohamed El Ghoneimy |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Blood transfusion medicine.diagnostic_test business.industry Urology medicine.medical_treatment Perforation (oil well) Nephroscopy medicine.disease Laser lithotripsy Surgery medicine.anatomical_structure Percutaneous nephrostomy medicine business Hydronephrosis Renal pelvis Pelvis |
| Zdroj: | Journal of Urology. 195 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | INTRODUCTION AND OBJECTIVES: To detect predicting factors for complications and stone clearance following pediatricMiniperc METHODS: From January 2012 to December 2014, children ( 12 yrs) with renal calculi who underwent Miniperc were included (79 children). Nephroscopy was done using 9.5 Fr semirigid ureteroscope through 14 Fr renal access sheath with Holmium:YAG laser lithotripsy. Finally, a 10 Fr percutaneous nephrostomy (PCN) was inserted. Effects of different factors on complications and stone free rate (SFR) were compared using Chi square or Fischer exact tests. RESULTS: Mean age was 58.1 31.3 months (6-144) while stone size was 16.3 7.9 mm (5-49). 22 (27.8%) stones were 20 mm while 8(10.1%) stones were branching. Multiple stones were present in 25(31.6%) patients. Single puncture was used except in 4 patients (5.1%). Operative time was 64.7 28.5 min (25-180). Complications were bleeding (3.8%), blood transfusion (1.3%), renal pelvis perforation (2.5%), postoperative leakage from PCN tract (5.1%) and fever (17.7%). SFR after primary-Miniperc was 86.1%. Second-look Miniperc was required in 3.8% with SFR improvement to 89.9%. Auxiliary ESWL was performed for 6.3% with SFR improvement to 94.9%. If the 3 patients with clinically insignificant residual fragments (CIRF) were included, SFR would be 98.7%. SFR was significantly lower in children with 2 stones (p 1⁄4 0.011), with stone size 20mm (p 1⁄4 0.005), with grade 2-3 hydronephrosis (p 1⁄4 0.019), and when stones were in other sites than pelvis (p 1⁄4 0.042) (Table 1). Complication rate was not affected by sex, degree of hydronephrosis, side, number, size, shape or site of stones (Table 2). CONCLUSIONS: Miniperc has high SFR in children using 14 Fr sheath and 9.5 Fr ureteroscope with acceptable complications. Stone clearance is affected by the presence of 2 stones, size 20mm, and when stones were in other sites than pelvis. Source of Funding: none |
| Databáze: | OpenAIRE |
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