Percutaneous nephrolithotomy for the management of stones in anomalous kidneys in children.

Abstract:

PURPOSE:We report percutaneous nephrolithotomy for the management of stones in anomalous kidneys in children. MATERIALS & METHODS:We performed PCNL on 6 children (one with bilateral stones), 3 boys and 3 girls with anomalous kidneys. Three had horseshoe kidneys, 2 malrotated kidneys, and one crossed fused ectopic kidney. Their age ranged from 5 to 12 years with a mean of 7.3 ± 3 years. Two patients had previous failed ESWL, 4 underwent PCNL for large stone burden. Mean stone burden was 324.9 ± 191.8 mm(2). Under fluoroscopic guidance we performed serial dilatation using Alken metal dilators. In 4 patients 17 Fr rigid nephroscope was used, in 2 patients 26 Fr nephroscope was utilized. Pneumatic lithotripsy was used for stone disintegration and forceps for stone extraction. RESULTS:A single stage PCNL resulted in complete stone clearance in 5 children, while one required a second look procedure. Operative time ranged from 25 to 70 min with a mean of 43.3 ± 17.8 min. None of the patients required blood transfusion. Perforation of the renal pelvis occurred in one patient and was managed by prolonged insertion of nephrostomy tube. Hospital stay ranged from 1 to 6 days with a mean of 3 ± 2 days. Postoperative fever occurred in one child and persisted for 3 days. All children were followed for 3 months and were stone free. Patient with bilateral stones performed ESWL on the contra lateral side. CONCLUSION:Children with stones in anomalous kidneys can be managed safely with PCNL when they are properly selected.

journal_name

J Pediatr Urol

authors

Abdeldaeim HM,Hamdy SA,Mokhless IA

doi

10.1016/j.jpurol.2011.02.025

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

239-43

issue

3

eissn

1477-5131

issn

1873-4898

pii

S1477-5131(11)00071-4

journal_volume

7

pub_type

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