title: Totally tubeless percutaneous nephrolithotomy: is it safe and effective in preschool children?
abstract: OBJECTIVE
  After the introduction of tubeless percutaneous nephrolithotomy (PNL), many studies conducted in adult patients have confirmed its efficacy and safety. There are limited studies reporting that tubeless PNL can be safely applied in children, however. Furthermore, there are no reports that evaluate the use of totally tubeless PNL in children. The present study evaluates the results of totally tubeless PNL in preschool children.
  
  
  METHODS
  The data of children seen in our clinic who were considered suitable for totally tubeless PNL were analyzed. Of 16 children, 8 patients underwent totally tubeless PNL (group 1) and 8 standard PNL (group 2). The two groups of patients were compared with regard to length of hospitalization, analgesic requirements, transfusion rates, hemoglobin (Hb) decrease, and immediate, early, and late complications.
  
  
  RESULTS
  The mean ages of the patients were 56.6 months (9-84 mos) and 56.0 months (5-84 mos), and the mean follow-up was 21.5 months (3-44 mos) and 43.4 months (36-54 mos) in groups 1 and 2, respectively. Both groups were similar with regard to age, stone size, Hb change, and complications. Although operation duration, hospitalization period, and analgesic requirement were less in the totally tubeless PNL group, these differences were not statistically significant.
  
  
  CONCLUSIONS
  The latest application of PNL, totally tubeless PNL, is also a safe and effective procedure in very small children if they are selected properly and if the surgeon has sufficient experience with the procedure. More studies with a higher number of participants are needed, however, to confirm that totally tubeless PNL increases the comfort of pediatric patients, decreases their hospitalization period, and is more economical.
authors.affiliation: Department of Urology, Selcuk University Meram Medical School, Akyokus Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozturk
authors.forename: Selcuk
authors.initials: S
authors.lastname: Guven
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kilinc
authors.forename: Emrah
authors.initials: E
authors.lastname: Topbaş
authors.forename: Mesut
authors.initials: M
authors.lastname: Piskin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arslan
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology / Q000628:therapy; D005791:Patient Care