Safety and efficacy of mini-percutaneous nephrolithotomy in management of renal stones in pediatric age group.

Abstract

Background: Currently, kidney stones are frequently observed in children and teens.

Objectives: To evaluate the safety and efficacy of mini-percutaneous nephrolithotomy (MPCNL) in managing renal stones in pediatric patients.

Patients and methods: This retrospective case series study included 115 consecutive patients aged < 11 years old who underwent MPCNL at Sulaimani Teaching Hospital and Mercy Medical City, Sulaimaniyah, Iraq, from January 2016 to March 2021. MPCNL was done on all patients through 16-20 Fr tracts. The stone-free rate, perioperative complications, tract number, operative time, postoperative hemoglobin change, and hospitalization time were assessed.

Results: The mean patients' age was 6.53 ± 1.3 years, and the mean stone burden was 2.073 ± 1.03 cm². After a single session of MPCNL, 93.25% of patients attained a complete stone clearance through a single tract in 109 patients (94%) and two tracts in 6 patients (5.2%). Hospitalization time, operative time, postoperative hemoglobin drop, and perioperative complications were 2.23 ± 0.93 days, 39.26 ± 8.22 min, 0.51 ± 0.34 g/dL, and 25.21%, respectively. No major complications (Clavien grade III and IV) were found. Most complications were minor, including Clavien grade I (n = 18, 15.6%) and II (n = 11, 9.56%), which were managed conservatively.

Conclusions: MPCNL is an effective and potentially safe procedure for treating complex renal stones in pediatric patients aged < 11 years, yielding an excellent stone-free rate and acceptable complications.