Determining the Efficacy and Safety of Supra Costal Percutaneous Nephrolithotomy (PCNL) and Subcostal PCNL in Children with Renal Calculi: A Retrospective Study

Description

Abstract (English)

Abstract
Aim: The aim of the present study was to evaluate the efficacy and safety of supra costal percutaneous
nephrolithotomy (PCNL) through the 11th intercostal space and compare it with subcostal PCNL in children with
renal calculi.
Methods: We retrospectively reviewed the electronic medical records of 100 children (65 boys and 35 girls) who
underwent PCNL procedures at our center for treatment of renal calculi for the period of 2 years at JLNMCH,
Bhagalpur, Bihar, India. Duration of study two years.
Results: The patients who underwent standard PCNL or combined supra costal and subcostal PCNL, 100 patients
were analyzed. Of these, 35 and 65 had a supra costal and subcostal access respectively. Stone size and location
of stone were comparable in both the groups. Most of the children had stone larger than 2 cm as an indication for
PCNL. The preoperative characteristics of the patients, urinary tracts and stones were comparable for both
treatment groups. Supra costal tracts were used for treatment of staghorn stones, upper calix stones, mid calix
stones and upper ureteral stones causing calculous anuria. There were no major complications (eg intrathoracic
complications, adjacent organ injury or bleeding requiring selective angiographic embolization, urgent renal
exploration, nephrectomy) following any of the procedures.
Conclusion: In conclusion, percutaneous nephrolithotomy for treating renal stones in children provides a high
degree of safety and efficacy whether a supra costal or subcostal approach is used.