title: Experience of percutaneous nephrolithotomy using adult-size instruments in children less than 5 years old.
abstract: OBJECTIVE
  We present our experience with percutaneous nephrolithotomy (PCNL) for management of large renal calculi in children less than 5 years old, and determine its safety and efficacy when using an adult-size device.
  
  
  METHODS
  Twenty patients younger than 5 years old underwent PCNL between August 2003 and July 2008. After retrograde catheterization, the nephrostomy tract dilated up to 26Fr. Then a 24-Fr rigid nephroscope was used and stones were fragmented with a pneumatic lithotripter.
  
  
  RESULTS
  Twenty patients with a mean age of 3.1 years underwent 26 PCNL procedures on 24 renal units. Four patients had bilateral renal stones. Five patients (20%) had staghorn stones, as did five of the other cases with multiple stones. Four patients had undergone previous stone surgery on the same side. All of the patients were managed with only one tract. The mean stone size was 33 (20-46)mm and average operative time was 93.25 (78-174)min. Stones were completely cleared in 79.16% of patients, which increased to 91.67% with adjunctive shockwave lithotripsy. The overall complication rate was 15.38% and mean hospital stay was 5.26 (3-8) days.
  
  
  CONCLUSIONS
  PCNL is an effective and safe treatment for renal calculi in children less than 5 years old, even when using instruments designed for adults.
authors.affiliation: Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University, M.C. (SBMU), Tehran, Islamic Republic of Iran. nouralizadeh@yahoo.com
authors.forename: Akbar
authors.initials: A
authors.lastname: Nouralizadeh
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.forename: Ahmad
authors.initials: A
authors.lastname: Javaherforooshzadeh
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Soltani
authors.forename: Farzam
authors.initials: F
authors.lastname: Tajali
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000628:therapy*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*