Mini-Percutaneous Nephrolithotomy for Complex Staghorn Stones in Children

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Nephrolithiasis Treatment

Background:

• Complex staghorn stones in children pose significant treatment challenges.
• Percutaneous nephrolithotomy (PCNL) is a standard treatment, with mini-PCNL offering a less invasive approach.

Purpose of the Study:

• To evaluate the safety and efficacy of pediatric mini-PCNL for complex staghorn stones.
• To assess complication rates and factors influencing stone clearance in pediatric patients.

Main Methods:

• Prospective analysis of 28 children undergoing pediatric mini-PCNL.
• Classification of stone complexity using Guy's stone score (GSS III and IV).
• Standardized mini-PCNL procedures performed in the prone position with F12 and F17 mini-nephroscopes.

Main Results:

• Initial stone-free rate was 78%, increasing to 89% post-ancillary procedures.
• Stone clearance was inversely related to stone complexity (GSS; p < 0.025).
• Major complications occurred in 17% of children; stone complexity and number of tracts were associated with complications.

Conclusions:

• Pediatric mini-PCNL is an effective and safe treatment for complex pediatric renal stones.
• Complication rates are acceptable and comparable to existing literature.
• Stone complexity is a significant factor influencing outcomes and complications in pediatric mini-PCNL.