title: Preoperative evaluation of pediatric kidney stone prior to percutaneous nephrolithotomy: is computed tomography really necessary?
abstract: The objective of the study was to investigate the precise role of computed tomography (CT) in preoperative radiologic evaluation and surgical planning of kidney stone in children prior to percutaneous nephrolithotomy (PNL). A total of 113 pediatric patients (aged ≤18 years) undergoing PNL for renal stone(s) in three referral hospitals between March 2010 and August 2012 were retrospectively evaluated. Depending on the preoperative radiologic evaluation, patients were divided into two groups. Those evaluated with CT were classified as group-1 (n = 50) and the remaining cases undergoing intravenous urography (IVU) examination were classified as group-2 (n = 63). Patient- and procedure-related variables and perioperative measures were compared between the groups. The mean age, stone size and localization were similar in both groups (p = 0.07, p = 0.57, p = 0.6, respectively). Although the postoperative hemoglobin drop was found to be significantly higher in group-2 (1.5 ± 1.3 vs. 0.9 ± 0.6 g/dL, p = 0.005), the mean operation time, fluoroscopic screening time, access number, overall success and complication rates were comparable (p = 0.06, p = 0.94, p = 0.75, p = 041, and p = 0.41, respectively). However, the mean hospitalization time was significantly prolonged in group-2 than in group-1 (p = 0.03). Our findings clearly demonstrate that, despite the key role of preoperative CT in particular patients with anatomically abnormal kidneys, IVU is a valuable alternative imaging modality with comparable radiation doses in children.
authors.affiliation: Department of Urology, Faculty of Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey, akadirtepeler@yahoo.com.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Tepeler
authors.forename: Ahmet Ali
authors.initials: AA
authors.lastname: Sancaktutar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Taskiran
authors.forename: Mesrur Selcuk
authors.initials: MS
authors.lastname: Silay
authors.forename: Mehmet Nuri
authors.initials: MN
authors.lastname: Bodakci
authors.forename: Tolga
authors.initials: T
authors.lastname: Akman
authors.forename: Orhan
authors.initials: O
authors.lastname: Tanriverdi
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Bozkurt
authors.forename: Abdullah
authors.initials: A
authors.lastname: Armagan
authors.forename: Kemal
authors.initials: K
authors.lastname: Sarica
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000000981:diagnostic imaging*; D008297:Male; D009403:Nephrostomy, Percutaneous; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014567:Urography
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