Percutaneous nephrolithotomy of bilateral staghorn renal calculi in pediatric patients: 12years experience in a tertiary care centre.

Abstract

To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (<15years) of bilateral staghorn calculi from 2004 to 2015. Staged PCNL was done after 2-3days if needed and opposite side PCNL was performed after 10-14days. Fifty-one patients with bilateral staghorn renal calculi underwent PCNL. The mean age of the study group was 10.25±2.13 (range 3-15). Mean stone burden was 778.3+613.4 (range 231-3850mm2). Forty-five patients underwent single puncture, twenty-two patients underwent double punctures whereas six patients underwent triple punctures during first session PCNL procedure. Most common puncture location was through the superior calyx (58.82%). The mean operating time was 77.25+30.21 (range 58-145). After the first session PCNL, the success rate was 76.47%. Thirteen patients (17 renal units) underwent relook PCNL and seven patients underwent ESWL. Overall complication noted in twenty-four (47.05%) cases. Most of the complications were minor grade. Percutaneous nephrolithotomy for staghorn calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.