title: Successful percutaneous nephrolithotomy in children: multicenter study on current status of its use, efficacy and complications using Clavien classification.
abstract: OBJECTIVE
  In this multicenter study we aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy in children with respect to different features and using the Clavien classification system.
  
  
  METHODS
  Percutaneous nephrolithotomies performed in children at 3 urology departments between March 2006 and May 2010 were included in the study. Results are presented for complex/simple renal stones, tubeless/totally tubeless percutaneous nephrolithotomy, simultaneous bilateral percutaneous nephrolithotomy, instrument size and age groups. Patients were divided into 3 distinct groups, infants and toddlers (3 years or younger, group 1), preschool children (4 to 7 years, group 2) and school children (8 to 16 years, group 3). Perioperative complications are presented according to the modified Clavien classification system.
  
  
  RESULTS
  A total of 140 percutaneous nephrolithotomies were performed in 130 patients (41.5% female, mean age 10.17 years). There were 23, 25 and 92 renal units in groups 1, 2 and 3, respectively. Pediatric instruments were used in 60 renal units and adult-sized instruments in 80. General assessment of complications showed Clavien grade I complications in 17 patients, II in 4, IIIa in 11 and IIIb in 7. There were no grade IV or V complications.
  
  
  CONCLUSIONS
  Percutaneous nephrolithotomy can be applied safely in children of varying ages, even infants. Complications, as assessed with Clavien classification, are comparable to those seen in adults provided there is enough experience with the technique.
authors.affiliation: Department of Urology, Selcuk University Meram Medical School, Konya Hospital, Turkey. selcukguven@selcuk.edu.tr
authors.forename: Selcuk
authors.initials: S
authors.lastname: Guven
authors.forename: Okan
authors.initials: O
authors.lastname: Istanbulluoglu
authors.forename: Umit
authors.initials: U
authors.lastname: Gul
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozturk
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Celik
authors.forename: Cem
authors.initials: C
authors.lastname: Aygün
authors.forename: Umit
authors.initials: U
authors.lastname: Ozdemir
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozturk
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkardes
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kilinc
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000145:classification / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies