Safety and Efficacy of Mini-percutaneous Nephrolithotomy in Management of Renal Stones in Pediatric Age Group

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Abstract

Background Kidney stones frequently observed in children and teens over the past 20 years. 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 Fourteen French (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 cm. After a single session of MPCNL, 93.25 ± 0.34 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 minutes, 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.

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