scholarly journals Percutaneous Nephrolithotomy (PCNL) for Management of Renal Stone in Pediatric Patient- Single Center Experience

2019 ◽  
Vol 16 (2) ◽  
pp. 76-79
Author(s):  
NI Bhuiyan ◽  
KMH Tawhid ◽  
MF Islam ◽  
Zahid H Bhuiyan ◽  
NIU Ahmed ◽  
...  

Introduction: Percutaneous nephrolithotomy (PCNL) is already an established method of management of renal stone in Bangladesh. Initially the procedure was restricted to adult age group only. Percutaneous Nephrolithotomy is the choice of procedure for management of renal stone in paediatric age group. Objectives: To see the out come of stone clearance by Percutaneous Nephrolithotomy(PCNL)in paediatric age group. Methods: This was a study in single centre since January' 09 to December 201 1 . Total 1 1 cases of renal stone in paediatric age group were managed by PCNL. The age ranges from 4 years to 15years, average 8.47 years. We use pneumatic lithotripters. Nephrostomy tubes and D-J stent were used in 7 cases. In 4 cases only DJ stent were used. Postoperative haematocrit and creatinine was measured routinely. Results: Total stone clearance was achieved in all cases. The major post-operative complication was urosepsis(n-1), managed conservatively. Total hospital stay was 3 to 5 days; average 3.5 days. Stents were removed after 2 weeks. Conclusions: PCNL is a suitable procedure for the management of renal stone in pediatric age group this needs expertise, longer learning curve under supervised training. Journal of Surgical Sciences (2012) Vol. 16 (2) : 76-79

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.


2020 ◽  
Vol 7 (4) ◽  
pp. 1127
Author(s):  
Pradeep K. Sharma ◽  
Shekhar Baweja ◽  
Vikas Aggarwal ◽  
Pawan Katti ◽  
Rupesh Nagori ◽  
...  

Background: Percutaneous nephrolithotomy (PCNL) has become a well-established procedure for the management of pediatric renal calculi. Paediatric PCNL has been performed using both adult and paediatric instruments. Objectives: To evaluate the safety, efficacy and complications using the Modified Clavien scoring system (MCSS) in children undergoing PCNL using adult sized instruments.Methods: All patients less than 16 years old were analyzed retrospectively in Western Rajasthan undergoing PCNL procedure at Dr. SN Medical College and Hospital from April 2016 to March 2019. All PCNL procedures were performed in prone position under general anaesthesia with fluoroscopic guidance and using adult size instruments. All the demographics, surgical data and perioperative information were collected.Results: Total 112 patients with 120 renal units (8 patients with bilateral stones), (66 boys and 46 girls), with a mean (range) age was 10.01±4.02 (2-16) years. The mean (range) stone size in our study was 28.94±1.10 (20-50 mm). Overall, stone-free rate after PCNL was 95%. Twenty five (25) children (20.8%) had operative complications; 23/25 (92%) had, Clavien grade I in 15 (60%), grade II in 8(32%) and all managed conservatively. 2 patients had hydropneumothorax, managed with ICD tube. Stone size, operative duration and haemoglobin drop were significantly associated with complications on Univariate analysis (p<0.05).Conclusions: In paedriatric age group PCNL is considered safe with MCSS showing grade I and grade II complications in majority (92%) of patients.


2021 ◽  
Author(s):  
Mustafa Berhuni ◽  
Cem Ozturkmen

Abstract Purpose: To investigate the short-term results of accelerated crosslinking (A-CXL) treatment for progressive keratoconus in the pediatric and adult age groups. Materials and methods: The records of the 62 eyes of 40 patients who had undergone the A-CXL procedure (9 mV/cm2, 10 min) for progressive keratoconus between January 2015 and January 2019 were evaluated retrospectively. The patients were divided into 2 groups as the pediatric group (aged 17 years or less) and the adult group (aged 18 years or more) for statistical analysis. Pre- and post- 12th month A-CXL best-corrected visual acuity (BCVA), maximum keratometry (Kmax), sim K1, sim K2, corneal thickness at the thinnest point (thCT), and corneal astigmatism (CA) values of the patient groups were recorded. Results: The 29 eyes of 16 patients were included in the pediatric group and the 33 eyes of 24 patients were included in the adult group. The mean age was 13.50±3.05 years in the pediatric group and 23.58±4.37 years in the adult group. A significant improvement in BCVA and a significant decrease in thCT values were present in both groups 12 months after the surgery compared to the preoperative period. A decrease was present in the Kmax, sim K1, sim K2 and CA values in the pediatric group, but was not statistically significant. The decrease in Kmax, sim K1 and sim K2 values compared to the preoperative period was significant in the adult group, but the decrease in CA values was not significant. When the two groups were compared at the end of 12 months, only the sim K1 value was significantly lower in the adult group, and there was no significant difference between the other measurements. Conclusions: Better visual acuity improvement, a higher flattening rate, and less progression occur after 12 months with A-CXL treatment for progressive keratoconus in the adult age group compared to the pediatric age group.


Author(s):  
Renuka S. Melkundi ◽  
Siddaram Patil

<p><strong>Background:</strong> Current study was done to know various clinical aspects of membranous patch over the tonsil.</p><p><strong>Methods: </strong>Data for the study were collected from patients who presented with membranous patch over the tonsil in the department of ENT at GIMS, Kalaburagi from January 2019 to December 2019. This is a prospective case study. 225 patients were included in the study. Once patient was presented to us detailed history, examination and necessary investigations were done.</p><p><strong>Results:</strong> The present study included 225 patients out of which out of which females were 132 (59%) and males were 93 (41%). The predominant clinical features were sore throat (225 cases), fever (212 cases), dysphagia (90 cases) and bull neck (45 cases). The most common cause of membranous patch over tonsil was found to be diphtheria (68%) followed by streptococcal tonsillitis (30%) and others (2%). In our study microbiological investigations like Albert stain was positive in 153 cases and culture was positive in 140 cases.</p><p><strong>Conclusions: </strong>It was observed in our study that diphtheria constitutes the majority (68%) and the incidence of adult is almost on par with paediatric age group. Despite of UIP we have seen increased incidence in the adult age group. Hence it requires the health agencies and the Government to increase immunization coverage, as India has witnessed the highest number of cases in the world for the year 2015. As evident from the shift in age groups being infected, adult booster dose has to be introduced at 10 years interval.</p>


2019 ◽  
Vol 52 (1) ◽  
pp. 25-30
Author(s):  
Turan Bayhan ◽  
Neriman Sarı ◽  
Ebru Atasever Akkaş ◽  
İnci Ergürhan İlhan

2014 ◽  
Vol 41 (3) ◽  
pp. 23-27
Author(s):  
MS Islam ◽  
NP Biswas ◽  
MZ Hossan ◽  
I Rahman ◽  
AKM K Alam ◽  
...  

To find out better treatment option in treating renal stone safely, expeditiously. A total of 90 patient were prospectively randomized for Percutaneous Nephrolithotomy (PCNL) (40) and Extra Corporeal Shock Wave Lithotripsy (ESWL) (50). Stone clearance, adjuvant procedures, hospital stay, post procedure morbidity, were compared for both methods. Stone clearance in PCNL and ESWL group was 87.50 and 66 percent respectively with a significant difference of clearance (P<0.05). Considering the stone size, in smaller stones, clearance was 87.50% and 72 50% among PCNL and ESWL group respectively without any significant difference (P>0.05). But in larger stones, stone clearance was 87.50% and 60.72% among PCNL and ESWL group respectively with significant difference in clearance between the groups (P<0.05). The rate of adjuvant procedures in PCNL and ESWL group was 12.50%, and 34% respectively. Requirement of adjuvant procedures were significantly higher in ESWL group (P<0.051 Post procedure hospital stay was significantly shorter in ESWL group than PCNL group (1.32 0.47 vs 4.52 1.99) with P yalue <0 05. Steinstrasse and Haematuria were significantly higher in ESWL group than PCNL group. Bleeding requiring transfusion, urinary cutaneous fistula and .fever were significantly higher in PCNL group than ESWL group. PCNL is more effective than ESWL in clearing larger renal stones. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18954 Bangladesh Medical Journal 2012 Vol.41(3): 23-27


2019 ◽  
Vol 7 (1) ◽  
pp. 117
Author(s):  
Suresh Kagalkar ◽  
Surendra Kumar Agarwal

Background: Nephrolithiasis is major problem in India. It is more prevalent in northern states of India and Karnataka is not an exception to this. Percutaneous nephrolithotomy (PCNL) has been accepted globally as a safe procedure with great success rate with less complication, and it is safe, effective, and suitable for pediatric cases. The aims and objectives of the study were to evaluate the indication of PCNL in children, to identify the complication, prevention and treatment of complication and to evaluate the efficacy and safely, management of kidney stones in children.Methods: Study period Aug 2015 July 2018, total 56 cases of renal stones in pediatric age group admitted in our Hospital, a tertiary care centre. All the patients evaluated for complete urine analysis, urine culture and sensitivity, complete hemogram, renal parameter, X ray KUB (kidney, ureter, and bladder), ultrasound KUB etc.Results: Small-stone (<2 cm) seen in 21.4% and large stone 64.2%. Following complications were noted- Pelvic perforations (3.5%), fever (7.1%) and hematuria (7.1%).Conclusions: PCNL is safe and effective procedure for the managements of renal stones in children with acceptable morbidity. 


2020 ◽  
Vol 7 (6) ◽  
pp. 1218
Author(s):  
Natasha L. Vageriya ◽  
Shivaji B. Mane ◽  
Taha Daginawala ◽  
Himangi Athawhale ◽  
Hussain Kotawala ◽  
...  

Background: Objective of this study is to explore various ureteric substitutes in pediatric age group and their outcomes.Methods: Retrospective analysis was done from 2003-2016, of all patients operated in this hospital that had undergone ureteral replacement. Thirteen such patients (5 from initially published paper (1) and 8 new patients) were followed up to find conduit patency, renal function and related complications with their outcomes assessed.Results: Ureteric substitution was done in 8 patients. Age of the patient ranged from 4 months to 8 years. Out of these for 2 patients monti tube was created; one with colon and other jejunum, rest of the 6 patient appendix was used. On follow up one patient had early appendico-ureteral leak requiring re-anastomosis and one patient had partial obstruction at 6 months corrected by dividing mesentry and untwisting appendix. With a mean follow up of 3.8 years all patients have preserved renal functions and drainage present. Also 5 patients of ureteral substitution performed at this institution and published prior were followed up with mean follow up of 10.4 years having no complaints with preserved function and unobstructed drainage.Conclusions: This small series supports that not only appendix and ileum but even colon as well as jejunum should be considered as Monti’s tube for ureteric replacement, when confronting with short ureter in paediatric age group.


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