Abstract:
Objective: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in
pediatric patients using adult-sized surgical equipment at our center.
Material and Methods: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24
or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of
surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up
details.
Results: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to
91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydropneumothorax
in one, perforation of the collecting system in three and urinoma in one. Complications were more common in
children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization
time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and
three patients, respectively.
Conclusion: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7
years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal
methods are associated with complications, PNL should be used only if other methods fail or are unavailable.
