SAFETY AND EFFICACY OF PERCUTANEOUS NEPHROLITHOTOMY IN INFANTS PRESENTING WITH OBSTRUCTIVE RENAL CALCULI AND ANURIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2015, Vol 4, Issue 33
Abstract
[b] BACKGROUND[/b]: Urolithiasis in infancy is rare but important health issue. Etiology is multi factorial. Optimal management of pediatric stone disease is still evolving. Infants with bilateral obstructive renal stones are unique group of patients in whom prompt evaluation and management is necessary. [b]AIMS AND OBJECTIVE[/b]: To evaluate safety and efficacy of PCNL in infants presentingwith bilateral obstructive renal calculi and anuria.[b] MATERIALS AND METHODS[/b]: From Nov. 2012 to March 2014, 18 renal units with calculi in 9 infants (6 boys, 3 girls) were treated with PCNL (Percutaneous Nephrolithotomy) at our institution. All infants presented with anuria, rised serum creatinin (mean 6.1mg/dl) and uremic symptoms due to bilateral obstructive renal calculi. All patients managed initially with peritoneal dialysis at nephrology unit, followed by bilateral DJ (Double J) stenting, then bilateral PCNL performed in two sittings. Mean age 8.5 months (4m to 12m), mean stone burden 1.7 cm (0.6cm to 3.0cm), 20 F pediatric nephroscope through 22F percutaneous access was used. Stones were fragmented with pneumatic lithotripter. [b]RESULTS[/b]: Mean operative time was 60.22 mins (30 mins to 90 mins). Complete stone clearance was done in all cases without need for second look PCNL. Mean post op serum creatinin is 0.6mg/dl. No patient required blood transfusion, developed urosepsis, or had a procedure related complications. [b]CONCLUSION[/b]: When performed by experienced urologists, PCNL is safe and effective procedure in infants presenting with bilateral obstructive renal calculi and anuria, provided these patients managed preoperatively with peritoneal dialysis and DJ stenting to optimise renal function and to relieve sepsis.
Authors and Affiliations
Yugesh M, Pandurangarao K, Prasad D. V. S. R. K, Srinivas S, Sudarshan G, Santosh B, Kalyan Varma , Satish Kumar
Keywords
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- EP ID EP95612
- DOI 10.14260/jemds/2015/832
- Views 130
- Downloads 0
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