Abstract:
We reported our experience with percutaneous
nephrolithotomy in children and compared the outcomes,
including the morbidity and success rates, regarding the
instruments of different sizes. One hundred and seventythree
paediatric patients, who underwent percutaneous
nephrolithotomy in our clinic between 1999 and 2013,
were assessed. According to the size of instruments used
during surgery, three different groups were formed and the
pre- and postopeartive outcomes were compared between
the groups. 76 girls and 97 boys with a mean age of 9.24
(B17) years were assessed. Stone-free rates were 75.6 %
in group 1 (n = 82) using 17 F nephroscope, 79.4 % in
group 2 (n = 73) using 24 F nephroscope and 72.2 % in
group 3 (n = 18) using 26 F nephroscope. Postoperative
fever was seen in four, five and one patient in group 1, 2
and 3, respectively. Urinary infection was seen in one
patient in group 1 and four patients in group 2. Mean
haematocrit drop and stone burden were significantly
lesser in group 1. No significant difference was seen in the
duration of nephrostomy and hospitalization between the
groups. The success rates obtained in the groups using
different instrument types (paediatric or adult) were similar.
However, age, weight, height, stone burden and
bleeding were significantly lesser in group 1 that used
paediatric type of instrument. As the most frequent complication
of PNL, bleeding seems to be associated with
stone burden, the diameter of dilatation and the calibre of
instrument. To decrease the particular complications,
paediatric type of instruments are convenient and do not
affect the success.
