Assesment of factors affecting outcome of Mini-PCNL by single-shot dilatation in Pediatric Patients.

Abstract

Objectives: The prevalence of stone disease in children is increasing, necessitating approaches using instruments of more suitable sizes for surgical treatment. We aim to convey our experience with Mini-PCNL.

Materials and methods: We retrospectively analyzed a total of 72 renal units that underwent single-shot dilatation Mini-PCNL(≤ 17.5F) between August 2017 and November 2024. Univariate and multivariate analyses were used to assess the factors for surgical success (no postoperative residual) and complications.

Results: Medians for our cohort were age at surgery was 5.5 years, operation time was 120 min, hospitalization time was 5 days, stone size was 2.04 cm². Overall SFR was 80.6%. We observed complications in 16 patients(%22.2). In univariate analysis; HU < 820, PCNL history, cystine stone, stone burden > 2 cm² and stone length > 29 mm were found to be associated with lower success. In the multivariate analysis results, patients with a previous history of PCNL (56% vs 93.6%) (p = 0.005) and patients with a stone burden ≥ 2 cm² (68.4% vs 94.1%) (p = 0.021) were found to be associated with less successful results. Univariate analysis revealed no single predictive factor for complication development.

Conclusion: Mini-PCNL is a surgical method that can be performed safely in the pediatric age group due to its high stone-free rate. However, it should be kept in mind that the success rates are lower in those with a history of PCNL due to anatomical challenges secondary to previous surgeries and with high stone burden. Patients with cystine stones deserve more effort to make them free of fragments.