Effectiveness of Percutaneous Nephrolithotomy in Children: A Retrospective Study of 76 Patients

Abstract

Purpose: To determine the effectiveness and safety of percutaneous nephrolithotomy (PCNL) and its use in kids with renal calculi.

Methods: It was a retrospective observational study involving 76 patients with renal stones undergoing PCNL in a Farooq Hospital between January 2022 and December 2024. There was an analysis of demographic characteristics, stone burden, operative details, stone-free rate, hospital stay, and complications. At week 4, ultrasonography and / or plain radiography were used to determine if the patient was stone-free and non-contrast computed tomography was used to evaluate the pertinent equivocal cases. Stone-free was characterized as complete lack of stones or any non-clinically significant residual stones less than 4 mm.

Results: The mean age was 9.3 ± 3.4 years. There were 44 males (57.9%) and 32 females (42.1%). The mean stone size was 22.4 ± 6.8 mm. Single stones were present in 49 patients (64.5%), while 27 (35.5%) had multiple stones. In 12 patients (15.8%), there were partial staghorn stones and 6 (7.9%), complete staghorn stones. Only 63 patients (82.9%), had only 1 percutaneous tract, and 13 (17.1) patients would not need only 1 percutaneous tract. The average healthcare time was 67.8 before and after +18.6 min and average they lost per hemolytic drop of hemoglobin was 1.2 before and after -0.7 g/dL. The initial stone-free rate and PCNL single session was 86.8 percentage (66/76) rate, after auxiliary procedures, this percentage was 94.7 percentage (72/76). Eighth patients (10.5%) had postoperative fever, 3 (3.9%) patients needed blood transfusion, 2 (2.6) patients required urine leakage, and 1 (1.3) patient had sepsis. No belly injury or death observed. The average length of stay at the hospital was 3.7 days.

Conclusion: PCNL is a safe and effective intervention that shows a high rate of stone-free and reasonable complication profile in the management of pediatric renal stones. It is still an option, particularly when children have numerous, large, and intricate calculi in the kidney.