PURPOSE: To assess the factors affecting complication rates of percutaneous nephrolithotomy (PCNL) in children.
PATIENTS AND METHODS: We retrospectively evaluated the data of 1205 renal units (RUs) in 1157 children treated with PCNL at 16 Turkish centers between 1991 and 2012. Of the patients, 28.3 % had previous history of urolithiasis. Complications were evaluated according to the Satava and modified Clavien grading system. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates.
RESULTS: A total of 515 females and 642 males were studied. Mean±SD patient age was 8.8±4.7 years (range 4 months to 17 years). Mean±SD stone size, operative time and postoperative hospital stay were 4.09±4.06 cm2, 93.5±48.6 minutes and 5.1±3.3 days, respectively. The stone free rate was 81.6%. A total of 359 complications occurred in 334 RUs (27.7%). They were intraoperative in 118 and postoperative in 241. While univariate analysis revealed that stone history, positive urine culture, operative time, hospitalization time, success, punctured calyx and location of the stone significantly affected the complication rates (p< 0.05); operation time, sheath size, mid calyceal puncture, and partial staghorn formation were the statistically significant parameters affecting complication rate on multivariate logistic regression analysis.
CONCLUSION: PCNL is the treatment of choice for most renal calculi in children, and it is an effective and safe technique in children with a high success rate and a low major complication rate. Significant factors should be considered by the clinicians to decrease the complication rates.
Written by:
Onal B, Dogan HS, Satar N, Bilen CY, Güneş A, Ozden E, Ozturk A, Demirci D, Istanbulluoğlu O, Gurocak S, Nazli O, Tanriverdi O, Kefi A, Korgali E, Silay MS, Inci K, Izol V, Altintas R, Kilicarslan H, Sarikaya S, Yalcin V, Aygun C, Gevher F, Aridogan IA, Tekgul S. Are you the author?
Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul.
Reference: J Urol. 2013 Oct 3. pii: S0022-5347(13)05560-2.
doi: 10.1016/j.juro.2013.09.061
PubMed Abstract
PMID: 24095906
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