Percutaneous nephrolithotomy in children: does age matter?
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- Dogan, H.S., Kilicarslan, H., Kordan, Y. et al. World J Urol (2011) 29: 725. doi:10.1007/s00345-011-0692-1
To compare the outcomes of percutaneous nephrolithotomy (PCNL) in 2 age groups.
Fifty-one renal units (RU) of 45 patients were operated between January 2006 and December 2010. In all patients, PCNL was performed by pediatric nephroscope of 17F size through a 20F Amplatz sheath. Patients were examined in 2 groups (Group1: ≤5 years, Group 2: >5 years) and outcomes were compared accordingly.
The mean age was 5.95 ± 3.63 years and male-to-female ratio was 23/22. The mean stone burden, operative time, and postoperative hospital stay were 4.24 ± 2.03 cm2, 94.30 ± 37.28 min, and 5.18 ± 2.97 days, respectively. In the postoperative period, 44 renal units (86.2%) were stone-free. Two age groups were similar regarding the postoperative hospital stay, gender distribution, stone location, stone composition, and complication rates. However, stone burden and number of access was less and stone-free rate was higher in younger age group.
The stone-free rate in preschool children is at least as good as older children without an increase in complication rates. The older children (>5 years) have a higher stone burden and need multiple accesses more frequently. The complications are mostly low grade and can be managed conservatively. Our results showed that PCNL in younger children as safe and effective as in the older children and age should not be considered as a limiting factor.