Micropercutaneous nephrolithotomy results in adults and pediatric patients: Is it safe for children?

Özet

Objective: To compare the safety and effectivity of micropercutaneous nephrolithotomy (MicroPNL) in adults and children. Material and methods: Twenty children and 20 adult patients who underwent MicroPNL were evaluated prospectively and consecutively, between June 2016 and December 2017, who were not suitable for retro- grade intrarenal surgery. Demographic data, stone free rates, length of hospitalization, duration of the opera- tion, fluoroscopy time, transfusion rates, requirement of double J (D-J) catheter implantation, and complications were examined. Results: Seventeen patients with complete data in each group were evaluated within the scope of the study. The mean age was 40.76 6 14.96 (18-67) years in adults and 5.38 6 3.84 (10 months to 14 years) years in children. There were no differences found between two groups for the mean operation time, fluoroscopy time, and the length of hospitalization. The total success rate was noted as 94.11% in each group (P ¼ 1). Whereas no complications were seen in adults, three complications were developed in the pediatric group (P ¼ .07). One patient in children group had steinstrasse. In addition, intraperitoneal fluid extravasation occurred in one pediatric patient during the operation. After paracentesis, post-operative period was observed uneventfully. Also, one pediatric patient had high fever due to the urinary tract infection. Whereas there was no need for perioperative D-J catheter implantation in adults, it was implanted in six (35.29%) pediatric patients, due to the fragmented stone burden (P ¼ .007). Conclusion: According to our results, MicroPNL is a safe and effective treatment option for symptomatic renal stones smaller than 2 cm, especially in adults. However, it needs more attention due to the risk of com- plications in pediatric population.