Abstract

Objective: To assess the safety and surgical outcomes of two different percutaneous nephrolithotomy (PNL) procedures (miniperc versus standard PNL) in pediatric renal stone disease.

Materials and methods: Over a 4-year period, a total of 31 consecutive children with a mean age of 10.3 years (range 3.5-16 years) undergoing two different PNL procedures were retrospectively evaluated. Depending on the type of procedure performed, children were divided into two groups: Group 1 (n=17) underwent a miniperc procedure, and Group 2 (n=16) underwent a standard PNL procedure with adult-size instruments. Clinical and surgical parameters including patient demographics, stone profiles, success rates in terms of stone-free status, complication rates, and the need for auxiliary procedures were compared between the groups.

Results: A total of 33 primary PNL procedures performed in 31 children were evaluated. The mean age was significantly lower in children undergoing the miniperc procedure (8.7 vs. 11.8 years old), and the number of accesses made was higher (1.41 vs. 1 port) (p<0.05). In addition, operation and fluoroscopy times, rates for blood transfusions, and the mean removal time for the nephrostomy catheter, were all comparable between groups. Similarly, the mean duration of hospitalization, the stone-free rates at 3 months, and the minor complication rates were similar in both groups. No major complications were noted in both approaches.

Conclusions: PNL is a safe treatment choice for pediatric renal stones with satisfactory stone-free rates and minimal complications. Despite the ongoing hesitancy to use adult-size equipment in this specific population during PNL procedures, our findings clearly revealed similar success and complication rates for the two different approaches.