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S9-2
(PP)
DO WE REALLY NEED A INTRAVENOUS PYELOGRAM (IVP) OR A NONCONTRAST
CT SCAN FOR A SAFE PCNL IN PAEDIATRIC POPULATION? - CHALLENGING THE
TRADITIONAL PROCEDURE
Sherjeel SAULAT
1
, Salman EL KHALID
2
and Waqar MEMON
2
1) The Kidney Centre PGTInstitute, Paediatric Urology Department, Karachi, PAKISTAN - 2) The Kidney Centre
PGTInstitute, Urology department, Karachi, PAKISTAN
PURPOSE
The purpose of this study is to analyze the success and complication rates of PCNL in children and to compare the
outcomes of the patients who underwent PCNL with only a X-Ray KUB and a Ultrasound (USG) KUB (Group 1) with the
group of patients who had an IVP or a non contrast CT Scan done before the procedure (Group 2).
MATERIAL AND METHODS
We retrospectively reviewed the data of 29 children (30 renal units) aged who underwent PCNL in our department from
November, 2014, to March, 2015. Patient's data including age, gender, stone size and site, pre & post-operative
hemoglobin levels, tract site, operating time, stone free rate, complications and hospitalization time were documented,
evaluated and compared. Successful outcome was a stone free renal unit on a postoperative USG KUB or a X Ray KUB.
RESULTS
30 PCNLs (Group I = 16, Group II = 14) were performed in 29 patients. The mean age was 6.8 ± 4.85 years.There was
no significant differences between the two groups regarding gender (p=0.14), stone size (p=0.07), operative time
(p=0.12), tract site (p=0.14) and hospital stay (p=0.19).Pre and post-operative mean hematocrit levels among the two
groups did not show any significant differences (p=0.294).The difference in stone free rates between the two groups
was not statistically significant (p=0.112). The overall stone free rate in both the groups came out to be 90% and 7%
having a 0.6 cm fragment and 3% having a 0.8 fragment.
CONCLUSIONS
PCNL has become the gold standard in treating paediatric urolithiasis.
We.Weconclude that as the expertise of
performing the procedure has remarkably increased therefore in experienced hands IVP and CT scan can be omitted and
conventional XRay KUB and USG KUB along with intraoperative fluoroscopy are enough to give acceptable stone free
rates.