Paediatric anatrophic nephrolithotomy; stone clearance — at what price?
Open Access
- 1 May 2000
- journal article
- research article
- Published by Wiley in BJU International
- Vol. 85 (7), 874-878
- https://doi.org/10.1046/j.1464-410x.2000.00626.x
Abstract
Objective To evaluate the functional outcome of anatrophic nephrolithotomy in children. Patients and methods All children undergoing anatrophic nephrolithotomy for complex branching and multiple renal calculi over an 11-year period were studied prospectively. Demographic data, treatment details and outcome, as assessed by X-ray, ultrasonography and isotope studies, were recorded. Anatrophic nephrolithotomy was carried out with surface cooling of the kidney followed by nephrostomy drainage for 5–7 days. Results Nine children (median age 4 years, range 7 months to 9 years) underwent anatrophic nephrolithotomy. Predisposing factors included urinary tract infection (by Proteus mirabilis) in all and hyper-calciuria in two children. The median (range) total ischaemic time at operation was 25 (15–40) min and the operative duration 150 (120–200) min. Three children required a blood transfusion. Stone clearance was incomplete in one child. There was no recurrent stone formation after a long-term follow-up (median 32 months, range 14–107) in the other patients. Isotope studies showed impaired split renal function (5%) in divided function in five children (range 6–16%) after surgery. Conclusion Anatrophic nephrolithotomy is an effective means of rendering children with branching calculi stone-free, but this study suggests that it leads to some further parenchymal damage.Keywords
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