Telli O et al, 2015: Does previous stone treatment in children generate a disadvantage or just the opposite?
Telli O, Haciyev P, Karimov S, Sarici H, Karakan T, Ozgur BC, Demirbas A, Resorlu B, Soygur T, Burgu B
Department of Paediatric Urology, School of Medicine, Ankara University, Sihhiye, Ankara, 06100, Turkey
In this study we aimed to determine the effects of previous open renal surgery, percutaneous nephrolithotomy and extracorporeal shockwave lithotripsy (ESWL) on the results and complications of subsequent percutaneous nephrolithotomy (PCNL) in pediatric patients. We reviewed the files of all 105 patients with 116 renal units (RU) undergoing PCNL at two main institutions between December 2000 and
February 2014. The 116 RUs were divided into four groups: primary PCNL patients with 44 RU (37.9 %) were categorized as group 1, 29 RU (25 %) with a history of failed ESWL on the same side were categorized as group 2, 23 RU (19.8 %) with previous PCNL surgery were
categorized as group 3 and 20 RU (17.2 %) with open renal surgery were categorized as group 4. Patient characteristics, mean operative time, mean fluoroscopy time, time to access the collecting system, hemoglobin change, number of more than 1 access, stone-free rates, postoperative hospitalization time and complications in four groups were compared. There were no differences between the groups in age, sex, mean stone size and stone laterality. Mean operative time, mean fluoroscopy time, time to access the collecting system, hemoglobin change, complication rates, number of more than one access hospitalization times were similar in the each group (p > 0.05 for each parameter). The stone-free rates after PCNL were 81.8 % in group 1, 79.3 % in group 2, 78.3 % in group 3 and 80 % in group 4 (p = 0.67). Percutaneous nephrolithotomy is effective and safe in children who have previously had open nephrolithotomy, history of ESWL or PCNL without no more complications than are seen with primary PCNL of kidneys and with similar success rate.
Urolithiasis. 2014 Nov 13. [Epub ahead of print]
This article deals with success and complications of PNL after previous stone therapy in children. Unfortunately the authors do not indicate when and why ESWL was done in those 29 RU (25 %) with a history of failed ESWL and what the reasons for failure were.