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Safety and efficacy of supracostal percutaneous nephrolithotomy in pediatric patients.
J Urol. 2008 Aug; 180(2):676-80.JU

Abstract

PURPOSE

This study was conducted to evaluate the safety and efficacy of the supracostal approach for percutaneous nephrolithotomy in pediatric patients.

MATERIALS AND METHODS

We retrospectively reviewed 60 percutaneous nephrolithotomy procedures done in 50 children (32 boys and 18 girls) between 2000 and 2007. Mean patient age was 7 +/- 4 years (range 9 months to 14 years). Noncontrast computerized tomography was the primary radiological investigation for most of the cases. The subcostal approach was used in 40 procedures, and the supracostal approach (above the 12th rib) was required in 20. We compared both approaches regarding preoperative characteristics, stone-free and complication rates, and the need for auxiliary procedures.

RESULTS

The preoperative characteristics of the patients, urinary tracts and stones were comparable for both treatment groups. There were no major complications. Significant bleeding requiring blood transfusion was observed in 3 patients (5%), transient fever in 3 (5%) and urinary leakage through the nephrostomy site in 3 (5%). The distribution of complications among subcostal and supracostal approaches was comparable. Of the 60 renal units 46 (77%) were stone-free after percutaneous nephrolithotomy at discharge from the hospital. Of the remaining 14 units 9 (15%) were stone-free after shock wave lithotripsy and 5 (8%) had insignificant residual stones. Therefore, the overall stone-free rate at 3 months was 92.5%. Comparing the subcostal and supracostal approaches, there were no significant differences between hospital stays, complication rates, unplanned auxiliary procedures, and stone-free rates at discharge home and at 3-month followup.

CONCLUSIONS

Percutaneous nephrolithotomy for treating renal stones in children provides a high degree of safety and efficacy whether a supracostal or subcostal approach is used.

Authors+Show Affiliations

Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18554648

Citation

El-Nahas, Ahmed R., et al. "Safety and Efficacy of Supracostal Percutaneous Nephrolithotomy in Pediatric Patients." The Journal of Urology, vol. 180, no. 2, 2008, pp. 676-80.
El-Nahas AR, Shokeir AA, El-Kenawy MR, et al. Safety and efficacy of supracostal percutaneous nephrolithotomy in pediatric patients. J Urol. 2008;180(2):676-80.
El-Nahas, A. R., Shokeir, A. A., El-Kenawy, M. R., Shoma, A. M., Eraky, I., El-Assmy, A. M., Ghaly, A. M., & El-Kappany, H. A. (2008). Safety and efficacy of supracostal percutaneous nephrolithotomy in pediatric patients. The Journal of Urology, 180(2), 676-80. https://doi.org/10.1016/j.juro.2008.04.046
El-Nahas AR, et al. Safety and Efficacy of Supracostal Percutaneous Nephrolithotomy in Pediatric Patients. J Urol. 2008;180(2):676-80. PubMed PMID: 18554648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and efficacy of supracostal percutaneous nephrolithotomy in pediatric patients. AU - El-Nahas,Ahmed R, AU - Shokeir,Ahmed A, AU - El-Kenawy,Mahmoud R, AU - Shoma,Ahmed M, AU - Eraky,Ibrahim, AU - El-Assmy,Ahmed M, AU - Ghaly,Ahmed M, AU - El-Kappany,Hamdy A, Y1 - 2008/06/12/ PY - 2007/11/27/received PY - 2008/6/17/pubmed PY - 2008/9/3/medline PY - 2008/6/17/entrez SP - 676 EP - 80 JF - The Journal of urology JO - J. Urol. VL - 180 IS - 2 N2 - PURPOSE: This study was conducted to evaluate the safety and efficacy of the supracostal approach for percutaneous nephrolithotomy in pediatric patients. MATERIALS AND METHODS: We retrospectively reviewed 60 percutaneous nephrolithotomy procedures done in 50 children (32 boys and 18 girls) between 2000 and 2007. Mean patient age was 7 +/- 4 years (range 9 months to 14 years). Noncontrast computerized tomography was the primary radiological investigation for most of the cases. The subcostal approach was used in 40 procedures, and the supracostal approach (above the 12th rib) was required in 20. We compared both approaches regarding preoperative characteristics, stone-free and complication rates, and the need for auxiliary procedures. RESULTS: The preoperative characteristics of the patients, urinary tracts and stones were comparable for both treatment groups. There were no major complications. Significant bleeding requiring blood transfusion was observed in 3 patients (5%), transient fever in 3 (5%) and urinary leakage through the nephrostomy site in 3 (5%). The distribution of complications among subcostal and supracostal approaches was comparable. Of the 60 renal units 46 (77%) were stone-free after percutaneous nephrolithotomy at discharge from the hospital. Of the remaining 14 units 9 (15%) were stone-free after shock wave lithotripsy and 5 (8%) had insignificant residual stones. Therefore, the overall stone-free rate at 3 months was 92.5%. Comparing the subcostal and supracostal approaches, there were no significant differences between hospital stays, complication rates, unplanned auxiliary procedures, and stone-free rates at discharge home and at 3-month followup. CONCLUSIONS: Percutaneous nephrolithotomy for treating renal stones in children provides a high degree of safety and efficacy whether a supracostal or subcostal approach is used. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/18554648/Safety_and_efficacy_of_supracostal_percutaneous_nephrolithotomy_in_pediatric_patients_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2008.04.046?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -