Is percutaneous nephrolithotomy effective and safe for children with solitary kidney?
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Jun 2022 · 1 min read
In brief
In brief
This retrospective study demonstrates that percutaneous nephrolithotomy (PCNL) is safe and effective for treating kidney stones in pediatric patients with solitary kidneys, achieving 97.4% stone-free rates comparable to bilateral kidney controls. While recovery metrics showed longer hospital stays in solitary kidney patients, renal function improved significantly in both groups with no major complications.
Written by the GCMD Library team from the article.
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.