Percutaneous nephrolithotomy of bilateral staghorn renal calculi in pediatric patients: 12 years experience in a tertiary care centre

Urolithiasis. 2017 Aug;45(4):393-399. doi: 10.1007/s00240-016-0920-7. Epub 2016 Sep 15.

Abstract

To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (<15 years) of bilateral staghorn calculi from 2004 to 2015. Staged PCNL was done after 2-3 days if needed and opposite side PCNL was performed after 10-14 days. Fifty-one patients with bilateral staghorn renal calculi underwent PCNL. The mean age of the study group was 10.25 ± 2.13 (range 3-15). Mean stone burden was 778.3 + 613.4 (range 231-3850 mm2). Forty-five patients underwent single puncture, twenty-two patients underwent double punctures whereas six patients underwent triple punctures during first session PCNL procedure. Most common puncture location was through the superior calyx (58.82 %). The mean operating time was 77.25 + 30.21 (range 58-145). After the first session PCNL, the success rate was 76.47 %. Thirteen patients (17 renal units) underwent relook PCNL and seven patients underwent ESWL. Overall complication noted in twenty-four (47.05 %) cases. Most of the complications were minor grade. Percutaneous nephrolithotomy for staghorn calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.

Keywords: Bilateral calculi; Paediatric PCNL; Staghorn calculi.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • India / epidemiology
  • Kidney Calices / diagnostic imaging
  • Kidney Calices / surgery
  • Lithotripsy / statistics & numerical data*
  • Male
  • Nephrolithotomy, Percutaneous / adverse effects
  • Nephrolithotomy, Percutaneous / methods
  • Nephrolithotomy, Percutaneous / statistics & numerical data*
  • Nephrostomy, Percutaneous / adverse effects
  • Nephrostomy, Percutaneous / methods
  • Nephrostomy, Percutaneous / statistics & numerical data
  • Operative Time
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Staghorn Calculi / diagnostic imaging
  • Staghorn Calculi / surgery*
  • Tertiary Care Centers / statistics & numerical data*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography
  • Urography