title: Effect of percutaneous nephrolithotomy on renal functions in children: assessment by quantitative SPECT of (99m)Tc-DMSA uptake by the kidneys.
abstract: OBJECTIVE
  To determine the impact of percutaneous nephrolithotomy (PNL) on global and regional renal function in children.
  
  
  METHODS
  In total, 40 children (41 renal units) undergoing PNL were included in this prospective study. All patients were evaluated using quantitative single-photon emission computed tomography (QSPECT) with technetium-99 m-dimercaptosuccinic acid ((99m)Tc-DMSA) examinations before and 3 months after surgery.
  
  
  RESULTS
  The mean age was 9.5 years (range, 3-16), and the mean stone size was 3.4 cm (range, 2-6.5). Of the cases, 39 (95%) were managed as being stone-free after a single session of PNL. After additional treatment procedures, 40 (97.5%) of the cases were managed as being stone-free. Of the 41 renal units, new focal cortical defects on (99m)Tc-DMSA scans were seen in 4 (9.7%) patients. Total relative uptake in the treated kidneys increased from 42.3% to 44.1%. The mean creatinine level before PNL was 1.18 ± 0.45 (0.8-1.6) mg/dL compared with 1.16 (0.7-1.5) mg/dL by the end of the follow-up period (not statistically significantly different, p > 0.05).
  
  
  CONCLUSIONS
  PNL in children is a safe and feasible method for the maximal clearance of stones. QSPECT of (99m)Tc-DMSA confirmed that renal function is preserved or even improved after percutaneous stone removal.
authors.affiliation: a Department of Urology , School of Medicine, Bulent Ecevit University , Zonguldak , Turkey .
authors.forename: Izzet
authors.initials: I
authors.lastname: Cicekbilek
authors.affiliation: b Department of Urology , School of Medicine, Canakkale Onsekiz Mart University , Canakkale , Turkey .
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu
authors.affiliation: c Department of Urology , School of Medicine, University of Giresun , Giresun , Turkey .
authors.forename: Ural
authors.initials: U
authors.lastname: Oguz
authors.affiliation: d Department of Urology , Ataturk Training and Research Hospital , Izmir , Turkey , and.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Kara
authors.affiliation: e Department of Urology , School of Medicine, University of Gazi , Ankara , Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Unsal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D019783:Technetium Tc 99m Dimercaptosuccinic Acid / Q000008:administration & dosage; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
keywords: Percutaneous nephrolithotomy; renal function; renal parenchymal scar; renal scintigraphy; stone disease