Minimally invasive percutaneous nephrolithotomy in children

Objective To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy in children.Methods Between 1998 and 2004, minimally invasive percutaneous nephrolithotomy was performed in 57 children 4 to 16 years of age (median age 8). The series consisted of 23 girls and 34 boys. Indications for minimally invasive percutaneous nephrolithotomy of 59 renal units included renal stones larger than 2 cm in diameter or staghorn calculus in 36 cases(including residual or recurrent stones after operation in 9 cases, obstructed kidney in 9 cases, failed ESWL in 7 cases,renal calculus with distal obstruction in 7 cases.Results Of the 59 cases 41 ( 69.5%) were stone-free after a single session of percutaneous nephrolithotomy. There were 4 incidences of intraoperative bleeding requiring blood transfusion and one incidence of excessive intraperitoneal extravasation of urine. With subsequent ESWL or repeat mini-PCNL the stone clearance rate was 86.4%.Conclusions Mini-PCNL is an effective procedure for treating renal and upper ureteral stones in children.