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Background: Percutaneous nephrolithotomy (PCNL) is widely performed in the treatment of kidney stones in children. The main risk of this therapy is hemorrhage that requires blood transfusion associated with an increased risk of kidney loss. This study was undertaken to assess the safety and efficacy of PCNL using ureteroscope and pneumatic intracorporeal lithotripsy in the treatment of pediatric renal calculi.
Methods: We studied 22 kidneys of 15 patients under 14 years who underwent PCNL in our hospital. The average age of these patients was 9.2 years (range 5-14 years). In 7 bilateral and 8 unilateral cases of 5 staghorn calculi, the average stone burden was 2.04 (0.9-4.5) cm. PCNL was performed with an X-ray-guided peripheral puncture. With a minimal dilatation of the urinary tract with ureteroscope and pneumatic intracorporeal lithotripsy, a staged approach was used for bilateral cases.
Results: Complete stone clearance was achieved in 20 of the 22 kidneys, giving an overall clearance rate of 91%. Mild fever (<39ºC, <2 days) was seen in 14 patients, whereas serious pyrexia was seen in 1. The decrease in the level of hemoglobin averaged 1.6 g/dl, but none of the patients required blood transfusion.
Conclusions: PCNL is a better treatment of choice for pediatric stone disease refractory to extracorporeal shock wave lithotripsy. To treat pediatric urolithiasis with PCNL using ureteroscope and pneumatic intracorporeal lithotripsy is safe and effective.
Key words: percutaneous nephrolithotomy; ureteroscope; pneumatic intracorporeal lithotripsy; children
World J Pediatr 2007;3(2):146-149
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