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S9: STONES
Moderators: Bob DeFoor (USA), Serdar Tekgül (Turkey)
ESPU Meeting on Thursday 15, October 2015, 13:50 - 14:34
13:50 - 13:55
S9-1
(LO)
★
PERCUTANEOUS LITHOTRIPSY (PCNL) IN TODDLERS
Sajid SULTAN, Sadaf ABA UMER KODWAVWALA, Bashir AHMED and Syed Adeeb Ul Hassan RIZVI
Sindh Institute of Urology & Transplantation, Philip G. Ransley Department of Paediatric Urology, Karachi, PAKISTAN
PURPOSE
To evaluate the stone clearance rate and peri and post operative blood transfusion rate after PCNL in children upto 3
years of age.
MATERIAL AND METHODS
Retrospective study of 276 renal units(RU) in children upto 3 years of age who underwent PCNL between Jan 2010 and
June 2014.The records were reviewed for gender,stone size(volume measured lengthxwidth),pre and post operative
Hb,approach, access site,sheath size,nephroscope size,disintegration technology,peri and post operative blood
transfusion,stone clearance and peri and post operative complications.
RESULTS
276 RU were reviewed with age range 7 months to 36 months.Off them 39 were between 7–12 months (Group A),114
were between 13-24 months (Group B)and 123 were between 25– 36 months(Group C).Mean stone size was 1.4 ± 0.92
cm
2
.In Group A stone size=1.0±0.66 cm
2
,in group B=1.3 ±0.83 cm
2
and in Group C size was 1.6±1.0 cm2.Mean
preoperative Hb was 10.5± 1.26 gm% in Group A,10.0±1.35 gm% in group B and 10.3±1.13 gm% in Group C.18-22 Fr
sheath was used in 82%,80% and 68% respectively.Supracostal approach used in 32%,39% and 45%
respectively.ultrasound was used for stone disintegration in 68%, 81% and 62% renal units in Group A,B and C
respectively.Overall blood transfusion rate was 22.4% (62 /276), with 38.5% in Group A, 22% in Group B and 18% in
Group C. Complete stone clearance seen in 96.2% after single session of PCNL. In Group A complete stone clearance
seen in 97% , in Group B 95% and in Group C 96.6%.Overall Complication rate which included fever, haematuria,
pleural effusion and perinephric collection, were 16.4%(45/276). It was 13.8% in Group A, 14.4% in Group B and 19%
in Group C.
CONCLUSIONS
PCNL is effective in toddlers with acceptable complications rate. It has an excellent stone clearance rate in this study
with a high blood transfusion requirement which is due to low pre operative Hb and very limited allowable blood loss.