title: Outcome of percutaneous nephrolithotomy in children having complex stones.
abstract: OBJECTIVE
  To review our experiences with percutaneous nephrolithotomy in children with complex renal calculi.
  
  
  METHODS
  We retrospectively analyzed the records of 31 children with complex renal calculi who were treated by percutaneous nephrolithotomy at 2 hospitals of our university between June 2003 and June 2008. The mean age of the patients was 10.4 years (range 22 months to 15 years). Three patients were aged < or =5 years. Stone clearance and complications were recorded.
  
  
  RESULTS
  The mean operating time (time from insertion of the ureteral catheter to placement of a nephrostomy tube) was 87.4 (range 50-180) min. In 2 patients the procedures were staged because of a large residual stone load. The extent of percutaneous tract dilation was undertaken taking patient age and the presence of hydronephrosis into consideration. Complete stone clearance with percutaneous nephrolithotomy was achieved in 21 (67.7%) of 31 patients. Adding extracorporeal lithotripsy increased total clearance to 24/31 (77.4%). The most common complication was bleeding that necessitated blood transfusion (7/31, 22.5%).
  
  
  CONCLUSIONS
  Percutaneous nephrolithotomy is as safe and effective in children as it is in adults. The clearance rate can be increased with dual therapy. Tract dilation should be tailored according to patient age and the extent of hydronephrosis.
authors.affiliation: Department of Urology, Baskent University, Konya Practice and Research Center, Konya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Gonen
authors.forename: Tahsin
authors.initials: T
authors.lastname: Turunc
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozturk
authors.forename: Cem
authors.initials: C
authors.lastname: Aygun
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkardes
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous; D012189:Retrospective Studies; D016896:Treatment Outcome