Outcome Of Percutaneous Nephrolithotomy In Preschool And School-Age Children-Single Center Experience

Area of Science:

• Pediatric Urology
• Nephrolithiasis Management
• Minimally Invasive Surgery

Background:

• Percutaneous nephrolithotomy (PCNL) efficacy is well-established in adults but less studied in children.
• Pediatric PCNL adoption is increasing for various age groups.
• Limited data exists on PCNL safety and efficacy in distinct pediatric age cohorts.

Purpose of the Study:

• To evaluate the safety and efficacy of PCNL in two pediatric age groups: preschool (≤7 years) and school-age (≥7 years).
• To compare stone-free rates and complication profiles between these pediatric age groups.

Main Methods:

• Retrospective review of 59 pediatric patients undergoing PCNL from December 2009 to May 2017.
• Patients categorized into two groups: preschool (n=27, mean age 4.8±2.1 years) and school-age (n=32, mean age 11.8±4.6 years).
• Analysis of stone size, operative time, hospital stay, stone clearance, and complications.

Main Results:

• Mean stone size (309±55 mm² vs 324±63 mm²) and operative time (150.1±38.7 min vs 166.3±39.6 min) were comparable between preschool and school-age groups.
• Mean hospital stay was similar (3.1±1.4 days vs 2.9±1.3 days).
• Monotherapy stone clearance was high in both groups (96.3% preschool, 93.75% school-age), reaching 100% with adjunctive extracorporeal shock wave lithotripsy.

Conclusions:

• PCNL demonstrates equal effectiveness in achieving stone-free rates for both preschool and school-age pediatric patients.
• Complication rates were not significantly different between the two age groups, indicating comparable safety profiles.