Abstract

Objective: Kidney stones are an important urological problem in both adults and children. They may be accompanied by metabolic disorders and genetic diseases and children make up approximately 20% of stone patients in our country. In our clinic, we evaluated the results from pre-school children 6 years of age and younger who underwent percutaneous nephrolithotomy (PNL) surgery.Material and Methods: Between March 2012 and June 2016, 54 pediatric patients aged 0-6 years were treated with PNL for stones that were larger than 2 cm or ESWL-resistant, after undergoing the appropriate tests at the Urology Department of the Harran University Faculty of Medicine.PNL operations were performed under general anesthesia. After cystoscopy in the supine position, a ureteral catheter was inserted, accompanied by C-arm fluoroscopy. Afterwards, the patients were placed in the prone position before the kidney was entered using a metal needle with a fluoroscopy attachment. We dilated the entrance with amplatzer renal dilators and entered with a 17 fr nephroscope. After the procedure, the nephrostomy catheter was placed in the renal sheath. 4 mm residual fragments remaining after the operation were accepted as clinically insignificant stone residues Results: A total of 54 patients underwent PNL operations; 23 females and 31 males. The mean age was 3.16± 0.8. 25 left-sided and 29

right-sided procedures were used. Three patients had bilateral kidney stones; co-administration was not staged. Mean stone size was

370±45 mm2

, while the mean operation time was 55 ± 21 minutes. 45 (83.3%) of the patients were stone-free after the operation. Postop, 2 (3.7%) had free fluid and ileus and 6 (11.1%) required additional blood products. They were stabilized with additional JJ stents. After

a nephrostomy drain, 4 (7.4%) patients had a JJ stent inserted. Average duration of the nephrostomy was 3.1 ± 0.9 days.

Conclusion: As with every age group, PNL was effective in treating stones larger than 2 cm as well as smaller ESWL-resistant specimens.

Success in preschool children is practically guaranteed, with a minimally invasive surgical procedure

Keywords: Kidney stone, Pre-school, PCNL

References

  1. Remzi D, Çakmak F, Erkan I. A study on urolithiasis incidence in Turkish school-age children. J Urol 1980;123:608.
  2. Oner A, Demircin G, Ipekcioglu H, Bulbul M, Ecin N. Etiological and clinical patterns of urolithiasis in Turkish children. Eur Urol 1997;31: 453-8.
  3. Woodside JR, Stevens GF, Stark GL, Borden TA, Ball WS. Percutaneous stone removal in children. J Urol 1985;134:1166-7.
  4. Unsal A, Resorlu B, Kara C, Bozkurt OF, Ozyuvali E. Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 2010;76:247-52.
  5. Guven S, Istanbulluoglu O, Ozturk A, Ozturk B, Piskin M, Cicek T, et al. Percutaneous nephrolithotomy is highly efficient and safe in infants and children under 3 years of age. Urol Int 2010;85:455-60.
  6. Lu P, Wang Z, Song R, Wang X, Wang X, Qi K, Dai Q, et al. The clinical efficacy of extracorporeal shock wave lithotripsy in pediatric urolithiasis: A systematic review and meta-analysis. Urolithiasis 2015;43:199-206.
  7. Akin Y, Yucel S. Long-term effects of pediatric extracorporeal shockwave lithotripsy on renal function. Res Rep Urol 2014;6:21-5.
  8. Dindo D, Demartines N, Clavien PA. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-13.
  9. Akıncı M, Esen T, Tellaloğlu S. Urinary stone disease in Turkey: An update epidemiological study. Eur Urol 1991;20:200-3.
  10. Ünsal A. Çocuklarda böbrek taşı tedavisinde perkütan nefrolitotomi. Endoüroloji Bülteni 2008;4:1-6.
  11. Dogan HS, Onal B, Satar N, Aygun C, Piskin M, Tanriverdi O, et al. Factors affecting complication rates of ureteroscopic lithotripsy in children: Results of multi-institutional retrospective analysis by Pediatric Stone Disease Study Group of Turkish Pediatric Urology Society. J Urol 2011;186:1035-40.
  12. Salerno A, Nappo SG, Matarazzo E, De Dominicis M, Caione P. Treatment of pediatric renal stones in a Western country: A changing pattern. J Pediatr Surg 2013;48:835-9.
  13. El-Hout Y, Elnaeema A, Farhat WA. Current status of retrograde intrarenal surgery for management of nephrolithiasis in children. Indian J Urol 2010;26:568-72.
  14. Wu HY, Docimo SG. Surgical management of children with urolithiasis. Urol Clin North Am 2004;31:589-94.
  15. Türk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, et al. Guidelines on Urolithiasis. European Association of Urology; Percutaneous nephrolithotomy (PNL). European Association of Urology 2014;5.6.1:31. https://uroweb.org/wp-content/ uploads/22-Urolithiasis_LR.pdf
  16. Kapoor R, Solanki F, Singhania P, Andankar M, Pathak HR. Safety and efficacy of percutaneous nephrolithotomy in the pediatric population. J Endourol 2008;22:637-40.
  17. Erdenetsesteg G, Manohar T, Singh H, Desai MR. Endourologic management of pediatric urolithiasis: Proposed clinical guidelines. J Endourol 2006;20:737-48.
  18. Onal B, Dogan HS, Satar N, Bilen CY, Güneş A, Ozden E, et al. Factors affecting complication rates of percutaneous nephrolithotomy in children: Results of a multi-institutional retrospective analysis by the Turkish Pediatric Urology Society. J Urol 2014;191:777-82.
  19. Zeren S, Satar N, Bayazit Y, Bayazit AK, Payasli K, Ozkeçeli R. Percutaneous nephrolithotomy in the management of pediatric renal calculi. J Endourol 2002;16:75-8.

Copyright and license

Copyright © 2018 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Katı B, Pelit ES, Dörterler ME, Ördek E, Akın Y, Çiftçi H, et al. The Results of Percutaneous Nephrolithotomy in Pre-School Age Children: Single Center Experience. Turk J Pediatr Dis [Internet]. 2018 Aug. 1 [cited 2025 Jul. 18];12(2):108-11. Available from: https://turkjpediatrdis.org/article/view/524