Our initial experience with percutaneous nephrolithotomy in children

• Main Authors: Mehmet Hanifi Okur, Mehmet Şerif Arslan, Bahattin Aydoğdu, Serkan Arslan, İbrahim Uygun, Abdurrahman Önen, Selçuk Otçu
• Format: Article
• Language: English
• Published: Dicle University Medical School 2014-03-01
• Series: Dicle Medical Journal
• Online Access: http://www.diclemedj.org/upload/sayi/31/Dicle%20Med%20J-01994.pdf

Objective: To present our initial experience on percutaneous nephrolithotomy (PCNL) in children between March 2012 and November 2013. Methods: 13 renal units of 12 patients underwent PCNL. Patients were evaluated in terms of age, preoperatively in terms of urine, blood count, urine culture, serum biochemical, and routine coagulation tests and radiological examinations, stone location, stone burden (according to plain radiograph), preoperative use of nephrostomy and average fluoroscopic manipulation time. To facilitate access, prior mechanical dilatation was performed nephrostomy access tract. After the PCNL procedure, we placed nephrostomy in all patients postoperatively. They were evaluated with regard to residual stone, complications (according to the Clavien classification) and outcomes. Results: Average age was 11 years (6-15). There was no abnormality in Laboratory Screening. Location of 11 stones was renal pelvis and 2 stones was pelvis + calyx. The average stone size was 260 mm². Preoperative acces were provided in 3 patients, others were intraoperatively. Average fluoroscopic manipulation time was 4,8 minutes (2-11). At the first postoperative day, 11 (85 %) patients achieved a completely stone-free state. Complications were seen in 3 patients; failure of renal access in one patient (Grade 3b), urine leakage was observed after surgery in one (Grade 3a), postoperative blood transfusion required in one patient (Grade 2). The hospital stay duration was 5,5 days (5-7 days). Conclusions: Pediatric PCNL is a minimal invasive procedure which provides high rate of stone free and good cosmetics. İf there is adequate facilities and equipment with experienced persons, this procedure can easily be used in pediatric surgery clinics.