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Minimally invasive percutaneous nephrolithotomy in preschool age children with kidney calculi (including stones induced by melamine-contaminated milk powder)
Pediatric Surgery International, 06/26/2012
Yan X et al. – Minimally invasive percutaneous nephrolithotomy (mini–PCNL) is a effective treatment for pediatric kidney stones refractory to extracorporeal shock wave lithotripsy, including stones induced by melamine–contaminated milk powder. The “mini–PCNL” technique, which uses ureteroscope and pneumatic intracorporeal lithotripsy, is a safe and feasible modality for treating renal calculi in preschool age children.
Methods- The authors studied 27 renal units in 20 patients of preschool age who underwent mini-PCNL at institute.
- The mean age was 42.6 months (range 14–68 months). The average stone burden was 1.85 cm (range 0.9–2.8 cm).
- Eight patients aged 14 to 58 months had been exposed to melamine-tainted powdered formula.
- The mini-PCNL was performed with an X-ray-guided peripheral puncture. Minimal tract dilatation was undertaken to fit a 14–16 Fr peel-away sheath.
- Complete clearance was achieved in 23 renal units (85.2 %) with mini-PCNL monotherapy. This has increased to 92.6 % after adjunctive ESWL.
- The average fall in hemoglobin was 1.28 g/dL. None of the patients required blood transfusion.
- The median length of hospital stay was 8.2 days. Patients were followed up every 6 months for 2 years.
- There has been only one recurrence of stone and no long-term complications.