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World Journal of Urology

, Volume 29, Issue 6, pp 725–729 | Cite as

Percutaneous nephrolithotomy in children: does age matter?

  • Hasan Serkan DoganEmail author
  • Hakan Kilicarslan
  • Yakup Kordan
  • Sinan Celen
  • Bulent Oktay
Original Article

Abstract

Purpose

To compare the outcomes of percutaneous nephrolithotomy (PCNL) in 2 age groups.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Percutaneous nephrolithotomy Stone Treatment Pediatric Children 

Notes

Conflict of interest statement

There is no conflict of interest.

References

  1. 1.
    Fernstrom I, Johannson B (1976) Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 10:257–259PubMedGoogle Scholar
  2. 2.
    Woodside JR, Stevens GF, Stark GL, Borden TA, Ball WS (1985) Percutaneous stone removal in children. J Urol 134:1166–1167PubMedGoogle Scholar
  3. 3.
    Tekgül S, Riedmiller H, Gerharz E, Hoebeke P, Kocvara R, Nijman R, Radmayr C, Stein R (2008) Guidelines on pediatric urology. EAU guidelines 2008:52–62Google Scholar
  4. 4.
    Zeren S, Satar N, Bayazit Y, Bayazit AK, Payasli K, Ozkeçeli R (2002) Percutaneous nephrolithotomy in the management of pediatric renal calculi. J Endourol 16:75–78PubMedCrossRefGoogle Scholar
  5. 5.
    Desai MR, Kukreja RA, Patel SH, Bapat SD (2004) Percutaneous nephrolithotomy for complex pediatric renal calculus disease. J Endourol 18:23–27PubMedCrossRefGoogle Scholar
  6. 6.
    Bilen CY, Koçak B, Kitirci G, Ozkaya O, Sarikaya S (2207) Percutaneous nephrolithotomy in children: lessons learned in 5 years at a single institution. J Urol 177:1867–1871CrossRefGoogle Scholar
  7. 7.
    Unsal A, Resorlu B, Kara C, Bozkurt OF, Ozyuvali E (2010) Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 76:247–252PubMedCrossRefGoogle Scholar
  8. 8.
    Aron M, Yadav R, Goel R, Hemal AK, Gupta NP (2005) Percutaneous nephrolithotomy for complete staghorn calculi in preschool children. J Endourol 19:968–972PubMedCrossRefGoogle Scholar
  9. 9.
    Salah MA, Toth C, Khan AM, Holman E (2004) Percutaneous nephrolithotomy in children: experience with 138 cases in a developing country. World J Urol 22:277–280PubMedCrossRefGoogle Scholar
  10. 10.
    Ozden E, Mercimek MN, Yakupoğlu YK, Ozkaya O, Sarikaya S (2011) Modified clavien classification in percutaneous nephrolithotomy: assessment of complications in children. J Urol 185:264–268PubMedCrossRefGoogle Scholar
  11. 11.
    Afshar K, McLorie G, Papanikolaou F, Malek R, Harvey E, Pippi-Salle JL, Bagli DJ, Khoury AE, Farhat W (2004) Outcome of small residual stone fragments following shock wave lithotripsy in children. J Urol 172:1600–1603PubMedCrossRefGoogle Scholar
  12. 12.
    Liu L, Zheng S, Xu Y, Wei Q (2010) Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in the supine versus prone position. J Endourol 24:1941–1946PubMedCrossRefGoogle Scholar
  13. 13.
    Karami H, Rezaei A, Mohammadhosseini M, Javanmard B, Mazloomfard M, Lotfi B (2010) Ultrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study. J Endourol 24:1357–1361PubMedCrossRefGoogle Scholar
  14. 14.
    Samad L, Qureshi S, Zaidi Z (2007) Does percutaneous nephrolithotomy in children cause significant renal scarring? J Pediatr Urol 3:36–39PubMedCrossRefGoogle Scholar
  15. 15.
    Dawaba MS, Shokeir AA, Hafez AT, Shoma AM, El-Sherbiny MT, Mokhtar A, Eraky I, El-Kenawy M, El-Kappany HA (2004) Percutaneous nephrolithotomy in children: early and late anatomical and functional results. J Urol 172:1078–1081PubMedCrossRefGoogle Scholar
  16. 16.
    Wadhwa P, Aron M, Bal CS, Dhanpatty B, Gupta NP (2007) Critical prospective appraisal of renal morphology and function in children undergoing shockwave lithotripsy and percutaneous nephrolithotomy. J Endourol 21:961–966PubMedCrossRefGoogle Scholar
  17. 17.
    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications. A new proposal with evaluation in a Cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRefGoogle Scholar
  18. 18.
    Badawy H, Salama A, Eissa M, Kotb E, Moro H, Shoukri I (1999) Percutaneous management of renal calculi: experience with percutaneous nephrolithotomy in 60 children. J Urol 162:1710–1713PubMedCrossRefGoogle Scholar
  19. 19.
    Holman E, Khan AM, Flasko T, Toth C, Salah MA (2004). Endoscopic management of pediatric urolithiasis in a developing country. Urology 63:159–62, discussion 162Google Scholar
  20. 20.
    Samad L, Aquil S, Zaidi Z (2006) Paediatric percutaneous nephrolithotomy: setting new frontiers. BJU Int 97:359–363PubMedCrossRefGoogle Scholar
  21. 21.
    Salah MA, Tallai B, Holman E, Khan MA, Toth G, Toth C (2005) Simultaneous bilateral percutaneous nephrolithotomy in children. BJU Int 95:137–139PubMedCrossRefGoogle Scholar
  22. 22.
    El-Nahas AR, Shokeir AA, El-Assmy AM, Shoma AM, Eraky I, El-Kenawy MR, El-Kappany HA (2006) Colonic perforation during percutaneous nephrolithotomy: study of risk factors. Urology 67:937–941PubMedCrossRefGoogle Scholar
  23. 23.
    Gerspach JM, Bellman GC, Stoller ML, Fugelso P (1997) Conservative management of colon injury following percutaneous renal surgery. Urology 49:831–836PubMedCrossRefGoogle Scholar
  24. 24.
    Gedik A, Tutus A, Kayan D, Yılmaz Y, Bircan K (2011) Percutaneous nephrolithotomy in pediatric patients: is computerized tomography a must? Urol Res 39:45–49PubMedCrossRefGoogle Scholar
  25. 25.
    Guven S, Istanbulluoglu O, Ozturk A, Ozturk B, Piskin M, Cicek T, Kilinc M, Ozkardes H, Arslan M (2010) Percutaneous nephrolithotomy is highly efficient and safe in infants and children under 3 years of age. Urol Int 85:455–460PubMedCrossRefGoogle Scholar
  26. 26.
    Khairy Salem H, Morsi HA, Omran A, Daw MA (2007) Tubeless percutaneous nephrolithotomy in children. J Pediatr Urol 3:235–238PubMedCrossRefGoogle Scholar
  27. 27.
    Bilen CY, Gunay M, Ozden E, Inci K, Sarikaya S, Tekgul S (2010) Tubeless minipercutaneous nephrolithotomy in infants and preschool children: a preliminary report. J Urol 184:2498–2502PubMedCrossRefGoogle Scholar
  28. 28.
    Ozturk A, Guven S, Kilinc M, Topbaş E, Piskin M, Arslan M (2010) Totally tubeless percutaneous nephrolithotomy: is it safe and effective in preschool children? J Endourol 24:1935–1939PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Hasan Serkan Dogan
    • 1
    Email author
  • Hakan Kilicarslan
    • 1
  • Yakup Kordan
    • 1
  • Sinan Celen
    • 1
  • Bulent Oktay
    • 1
  1. 1.Department of Urology, Faculty of MedicineUludag UniversityBursa, GorukleTurkey

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