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Pediatric Surgery International

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15-06-2022 | Nephrostomy | Original Article

Is percutaneous nephrolithotomy effective and safe for children with solitary kidney?

Authors: Kadir Karkin, Hakan Erçil

Published in: Pediatric Surgery International | Issue 8/2022

Abstract

Purpose

To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) in pediatric patients with solitary kidneys and kidney stones.

Methods

Thirty-nine patients (group A) with solitary kidney under 18 years of age who underwent PCNL between January 2015 and December 2021 were evaluated and analyzed. Forty-two patients (group B) with bilateral kidneys who underwent PCNL were determined as the control group and included in the analysis. Intraoperative and postoperative data such as demographic data, stone localization, bleeding and transfusion rates, operation time, complications, hospital stay, stone-free rates (SFR) and kidney function (glomerular filtration rate (eGFR)) were compared between the two groups. PCNL was performed with all patients in the prone position. Only a laser was used to fragment the stone in all cases. Stone-free was defined as the absence of residual stone fragments ≥ 2 mm in maximum diameter at 3 months on kidney, ureter and bladder (KUB) graphy, ultrasonography (US) or non-contrast tomography (NCCT).

Results

The mean ages of the patients in Group A and B were 7.5 ± 2.6 and 8.5 ± 3.1 years, respectively. The mean stone size was 16.5 ± 4.1 and 17.0 ± 3.2 mm in group A and group B, respectively (p = 0.49). SFR rates in Groups A and B were 97.4% and 95.2% (p = 1.00). There was no statistically significant difference in terms of the operation time, perioperative blood transfusion, hemoglobin decrease and Clavien grade 1 complication rates (p > 0.05). However, double-J (JJ) stent placement, duration of nephrostomy and hospital stay were longer in the solitary kidney group (p < 0.05). There was a significant improvement in creatinine and eGFR levels in both groups at the postoperative sixth month (p < 0.05).

Conclusion

Our results show that PCNL is a safe and effective method in pediatric patients with solitary kidneys.

Schwarz RD, Dwyer NT (2006) Pediatric kidney stones: long-term outcomes. Urology 67(4):812–816. https://doi.org/10.1016/j.urology.2005.10.020CrossRefPubMed

Tekgül S, Stein R, Bogaert G, Nijman RJ, Quaedackers J, Silay MS et al (2021) European association of urology and European society for paediatric urology guidelines on paediatric urinary stone disease. Eur Urol Focus. https://doi.org/10.1016/j.euf.2021.05.006CrossRefPubMed

Nouralizadeh A, Basiri A, Javaherforooshzadeh A, Soltani MH, Tajali F (2009) Experience of percutaneous nephrolithotomy using adult-size instruments in children less than 5 years old. J Pediatr Urol 5(5):351–354. https://doi.org/10.1016/j.jpurol.2008.12.009CrossRefPubMed

Schuster TK, Smaldone MC, Averch TD, Ost MC (2009) Percutaneous nephrolithotomy in children. J Endourol 23(10):1699–1705. https://doi.org/10.1089/end.2009.0198CrossRefPubMed

Soucy F, Ko R, Duvdevani M, Nott L, Denstedt JD, Razvi H (2009) Percutaneous nephrolithotomy for staghorn calculi: a single center’s experience over 15 years. J Endourol 23(10):1669–1673. https://doi.org/10.1089/end.2009.1534CrossRefPubMed

Wolf JS Jr, Clayman RV (1997) Percutaneous nephrostolithotomy: what is its role in 1997? Urol Clin N Am 24(1):43–58. https://doi.org/10.1016/S0094-0143(05)70353-0CrossRef

Shokeir AA, Sheir KZ, El-Nahas AR, El-Assmy AM, Eassa W, El-Kappany HA (2006) Treatment of renal stones in children: a comparison between percutaneous nephrolithotomy and shock wave lithotripsy. J Urol 176(2):706–710. https://doi.org/10.1016/j.juro.2006.03.080CrossRefPubMed

Onal B, Dogan C, Citgez S, Argun B, Onder AU, Sever L, Erozenci A (2013) Percutaneous nephrolithotomy in children with cystine stone: long-term outcomes from a single institution. J Urol 190(1):234–238. https://doi.org/10.1016/j.juro.2013.01.016CrossRefPubMed

Cockcroft DW, Gault H (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16(1):31–41. https://doi.org/10.1159/000180580CrossRefPubMed

10.

Fernström I, Johansson B (1976) Percutaneous pyelolithotomy: a new extractio technique. Scand J Urol Nephrol 10(3):257–259. https://doi.org/10.1080/21681805.1976.11882084CrossRefPubMed

11.

Helal M, Black T, Lockhart J, Fıgueroa TE (1997) The Hickman peel-away sheath: alternative for pediatric percutaneous nephrolithotomy. J Endourol 11(3):171–172. https://doi.org/10.1089/end.1997.11.171CrossRefPubMed

12.

Jackman SV, Hedican SP, Peters CA, Docimo SG (1998) Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 52(4):697–701. https://doi.org/10.1016/S0090-4295(98)00315-XCrossRefPubMed

13.

Sabnis RB, Jagtap J, Mishra S, Desai M (2012) Treating renal calculi 1–2 cm in diameter with minipercutaneous or retrograde intrarenal surgery: a prospective comparative study. BJU Int 110(8):E346. https://doi.org/10.1111/j.1464-410X.2012.11089.xCrossRefPubMed

14.

Proietti S, Giusti G, Desai M, Ganpule AP (2017) A critical review of miniaturised percutaneous nephrolithotomy: is smaller better? Eur Urol Focus 3(1):56–61. https://doi.org/10.1016/j.euf.2017.05.001CrossRefPubMed

15.

Koga S, Arakaki Y, Matsuoka M, Ohyama C (1991) Staghorn calculi–long-term results of management. Br J Urol 68(2):122–124. https://doi.org/10.1111/j.1464-410X.1991.tb15278.xCrossRefPubMed

16.

El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, Eraky I, El-Kappany HA (2007) Post-percutaneous nephrolithotomy extensive hemorrhage: a study of risk factors. J Urol 177(2):576–579. https://doi.org/10.1016/j.juro.2006.09.048CrossRefPubMed

17.

Darabi MM, Shakibi MH (2008) Percutaneous nephrolithotomy in patients with solitary kidney. Urol J 5(1):24–27. https://doi.org/10.22037/uj.v5i1.67CrossRef

18.

Bucuras V, Gopalakrishnam G, Wolf JS Jr, Sun Y, Bianchi G, Erdogru T, de la Rosette J, on behalf of the CROES PCNL Study Group (2012) The clinical research office of the endourological society percutaneous nephrolithotomy global study: nephrolithotomy in 189 patients with solitary kidneys. J Endourol 26(4):336–341. https://doi.org/10.1089/end.2011.0169CrossRefPubMed

19.

Resorlu B, Kara C, Oguz U, Bayindir M, Unsal A (2011) Percutaneous nephrolithotomy for complex caliceal and staghorn stones in patients with solitary kidney. Urol Res 39(3):171–176. https://doi.org/10.1007/s00240-010-0321-2CrossRefPubMed

20.

Akman T, Binbay M, Tekinarslan E, Ozkuvanci U, Kezer C, Erbin A, Yaser-Muslumanoglu A (2011) Outcomes of percutaneous nephrolithotomy in patients with solitary kidneys: a single-center experience. Urology 78(2):272–276. https://doi.org/10.1016/j.urology.2010.12.029CrossRefPubMed

21.

Jones P, Bennett G, Aboumarzouk OM, Griffin S, Somani BK (2017) Role of minimally invasive percutaneous nephrolithotomy techniques—micro and ultra-mini PCNL (<15F) in the pediatric population: a systematic review. J Endourol 31(9):816–824. https://doi.org/10.1089/end.2017.0136CrossRefPubMed

22.

Ganpule AP, Mishra S, Desai MR (2010) Percutaneous nephrolithotomy for pediatric urolithiasis. Indian J Urol 26(4):549. https://doi.org/10.4103/0970-1591.74458CrossRefPubMedPubMedCentral

23.

Kaygısız O, Satar N, Güneş A, Doğan HS, Erözenci A, Özden E, Önal B (2018) Factors predicting postoperative febrile urinary tract infection following percutaneous nephrolithotomy in prepubertal children. J Pediatr Urol 14(5):448-e1. https://doi.org/10.1016/j.jpurol.2018.04.010CrossRefPubMed

24.

Agrawal MS, Agarwal M (2013) Percutaneous nephrolithotomy: large tube, small tube, tubeless, or totally tubeless? Indian J Urol 29(3):219. https://doi.org/10.4103/0970-1591.117285CrossRefPubMedPubMedCentral

25.

Celik H, Camtosun A, Dede O, Dagguli M, Altintas R, Tasdemir C (2017) Comparison of the results of pediatric percutaneous nephrolithotomy with different sized instruments. Urolithiasis 45(2):203–208. https://doi.org/10.1007/s00240-016-0887-4CrossRefPubMed

Title: Is percutaneous nephrolithotomy effective and safe for children with solitary kidney?
Authors: Kadir Karkin
Hakan Erçil
Publication date: 15-06-2022
Publisher: Springer Berlin Heidelberg
Keywords: Nephrostomy
Nephrostomy
Published in: Pediatric Surgery International / Issue 8/2022
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05147-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is percutaneous nephrolithotomy effective and safe for children with solitary kidney?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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