PERCUTANEOUS NEPHROLITHOTOMY IN CHILDREN: EARLY AND LATE ANATOMICAL AND FUNCTIONAL RESULTS
| Autor: | Hamdy A. El-Kappany, Mohamed T. El-Sherbiny, Mohamed Dawaba, Ashraf T. Hafez, Ahmed M. Shoma, Ahmed A. Shokeir, Ibrahim Eraky, Mahmoud R. El-Kenawy, Alaa A. Mokhtar |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Adolescent Urology Urinary system medicine.medical_treatment Perforation (oil well) Renal function Lithotripsy urologic and male genital diseases Kidney Calculi Recurrence Internal medicine medicine Humans Child Percutaneous nephrolithotomy Nephrostomy Percutaneous Kidney business.industry Infant Length of Stay Surgery medicine.anatomical_structure Child Preschool Female business Renal pelvis Glomerular Filtration Rate |
| Zdroj: | Journal of Urology. 172:1078-1081 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1097/01.ju.0000134889.99329.f7 |
| Popis: | Purpose: We report our experience with percutaneous nephrolithotomy (PCNL) in children, and evaluate its early and late anatomical and functional results. Materials and Methods: A total of 65 children with renal calculi were treated with PCNL. Patient age at operation ranged from 9 months to 16 years (mean ± SD of 5.9 ± 0.9 years), and 27 (41.5%) were younger than 5 years. Seven patients had bilateral renal stones and, therefore, the number of kidneys treated by PCNL was 72. The patients were followed regularly every 3 months during year 1 and every 6 months thereafter. Renal scans using 99m technetium dimercapto-succinic acid for detection of renal scarring and 99m technetium diethylenetetramine-pentaacetic acid for determination of selective glomerular filtration rate (GFR) were performed in all patients at least once during followup, which ranged from 6 to 72 months (mean ± SD 40 ± 10). Results: Early complications included significant intraoperative bleeding in 1 case, renal pelvis perforation in 1 and transient fever in 2. Mean hospital stay ± SD was 3 ± 1.2 days (range 2 to 21). Of the renal units 62 (86%) were stone-free after a single PCNL, and the remaining 10 with residual stones were treated with a second look PCNL (4) and shock wave lithotripsy (6). Stone-free rates at hospital discharge and at 3 months were 93% and 100%, respectively. During followup 6 patients (9%) had recurrence of small renal stones and were successfully treated with shock wave lithotripsy. None of the kidneys had scarring on dimercapto-succinic acid renal scan. All of the kidneys except 1 showed improvement or stabilization of the corresponding GFR determined by diethylenetetraminepentaacetic acid renal scan. Comparison of the mean preoperative GFR of the corresponding kidney (28.8 ± 11.2 ml per minute) with mean value at followup (36.1 ± 9.9) showed an increase of statistical significance (p Conclusions: PCNL is a safe and effective procedure for the treatment of children with renal calculi. At long-term followup the procedure improves renal function without renal scarring. |
| Databáze: | OpenAIRE |
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