Paper Information

Title: 

PERCUTANEOUS NEPHRODITHOTOMY (PCNL) IN PEDIATRIC

Type: PAPER
Author(s): DARABI M.*
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PURPOSE: EXTRACORPOREAL SHOCKWAVE UTHOTRIPSY (ESWL) AND PCNL ARE THE NEW METHODS IN THE MANAGEMENT OF ADULT RENAL STONES. ALTHOUGH ESWL ARE PERFORMED IN PEDIATRIC GROUPS WIDESPREADLY BUT REPORTS OF PCNL IN THIS AGE GROUP IS IN A LOWER RATE. IN THIS STUDY WE DEMONSTRATED OUR RESULTS OF PCNL IN PEDIATRIC.
MATERIALS & METHODS: FROM 1997 TO 2002, A TOTAL OF 47 CHILDREN 3.5 TO 15 YEARS OLD WITH RENAL STONES WAS MANAGED BY PCNL. TWENTY EIGHT PATIENTS (60%) WERE FEMALE AND 19 PATIENTS (40%) HAD A HISTORY OF UNSUCCESSFUL ESWL. THIRTY ONE PATIENTS HAD SINGLE RENAL STONE, 9 PATIENTS HAD STAG HORN STONES AND IN 7 PATIENTS MULTIPLE RENAL STONES WERE FOUND. INTRAVENOUS UROGRAM (IVU) WERE PERFORMED IN ALL PATIENTS BEFORE PCNL.
BY USING GENERAL ANESTHESIA 4 FR. URETERAL CATHETER INSERTED AND RETROGRADE URETROGRAPHY WAS DONE.
VISUALIZATION OF THE PYELOCALICEAL SYSTEM WAS ACHIEVED AND PERCUTANEOUS RENAL ACCESS WAS OBTAINED. FOLLOWING TREAT DILATION, NEPHROSCOPY WAS PERFORMED AND STONES WERE FRAGMENTED (BY ULTRASOUND AND ELECTROHYDROLIC LITHOCLAST) AND REMOVED.
RESULTS: STONES WERE FRAGMENTED BY ULTRASOUND IN 30 PATIENTS, BY ELECTROHYDROLIC IN 8 PATIENTS AND IN 9 PATIENTS STONES ERE REMOVED BY FORCEPS. STONE FREE RATE WAS 100% IN 33 PATIENTS (73.3%). IN 5 PATIENTS WITH STAGHOUND CALCULUS, RESIDUAL STONES WERE SEEN AND THEY CANDIDATED FOR ESWL. IN PATIENTS WITH MULTIPLE RENAL STONES, HE LEADER STONE WAS REMOVED AND ESWL WAS PERFORMED FOR THE REMAINING STONES. WE HAD SOME COMPLICATION IN 11 PATIENTS. FOUR PATIENTS HAD FEVER AND COLIC AND IN 1 PATIENT COLON PERFORMATION OCCURRED BUT ALL MANAGED BY MEDICAL TREATMENT.
CONCLUSIONS: IN OUR EXPERIENCE PCNL IS A USEFUL AND EFFECTIVE METHOD OF STONE TREATMENT N PEDIATRIC AND WE OFFER THIS PROCEDURE IN PEDIATRIC STONES.

 
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