title: Percutaneous nephrolithotomy of bilateral staghorn renal calculi in pediatric patients: 12 years experience in a tertiary care centre.
abstract: To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (<15 years) of bilateral staghorn calculi from 2004 to 2015. Staged PCNL was done after 2-3 days if needed and opposite side PCNL was performed after 10-14 days. Fifty-one patients with bilateral staghorn renal calculi underwent PCNL. The mean age of the study group was 10.25 ± 2.13 (range 3-15). Mean stone burden was 778.3 + 613.4 (range 231-3850 mm2). Forty-five patients underwent single puncture, twenty-two patients underwent double punctures whereas six patients underwent triple punctures during first session PCNL procedure. Most common puncture location was through the superior calyx (58.82 %). The mean operating time was 77.25 + 30.21 (range 58-145). After the first session PCNL, the success rate was 76.47 %. Thirteen patients (17 renal units) underwent relook PCNL and seven patients underwent ESWL. Overall complication noted in twenty-four (47.05 %) cases. Most of the complications were minor grade. Percutaneous nephrolithotomy for staghorn calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India. purkaitbimalesh1@gmail.com.
authors.forename: Bimalesh
authors.initials: B
authors.lastname: Purkait
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Sokhal
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Satya Narayan
authors.initials: SN
authors.lastname: Sankhwar
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007670:Kidney Calices / Q000000981:diagnostic imaging / Q000601:surgery; D008096:Lithotripsy / Q000706:statistics & numerical data*; D008297:Male; D000074642:Nephrolithotomy, Percutaneous / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000069856:Staghorn Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014567:Urography
keywords: Bilateral calculi; Paediatric PCNL; Staghorn calculi