title: Percutaneous nephrolithotomy in children in different age groups: data from the Clinical Research Office of the Endourological Society (CROES) Percutaneous Nephrolithotomy Global Study.
abstract: OBJECTIVE
  To present the overall results of paediatric percutaneous nephrolithotomy (PCNL) compared with adults. To present the indications, complications and outcomes of patients treated in the participating centres in the PCNL Global Study, as categorised in different age groups.
  
  
  METHODS
  The Clinical Research Office of the Endourological Society (CROES) Study was conducted from November 2007 to December 2009, and included 96 centres and >5800 patients. All children aged ≤14 years in the PCNL Global Study database were the focus of the study.
  
  
  RESULTS
  In all, 107 children aged ≤14 years were included in the analysis. The PCNL procedure was conducted in 13 patients (12.1%) in the supine position; tubeless PCNL was performed in 15 patients (14%); and balloon dilatation was preferred in 22 patients (20.5%). The overall mean operative duration was 97.02 min; blood transfusion rate, fever and stone-free rates were 9%, 14% and 70.1%, respectively. A comparison of the paediatric PCNL cases according to age groups showed no statistically significant differences between the subgroups for patient characteristics, co-morbidities, renal anomalies, or previous surgical history. In the evaluation of the operative details, the mean sheath size and nephrostomy tube size were larger in school-age children than the preschool children (P = 0.01 and 0.002, respectively). There was a difference in the preferred methods for confirming stone-free status, with ultrasonography preferred more in preschool children (P < 0.001). The PCNL procedure position, puncture site, dilatation method, postoperative tube application, and surgical outcomes were comparable in school- and preschool-age children. While operative details showed some differences between children and adults, the surgical outcomes were comparable.
  
  
  CONCLUSIONS
  A considerable number (45.7%) of the paediatric patients had a previous history of stone intervention. Based on the findings of the present study, we can suggest that PCNL can be applied safely and effectively in children in different age groups. Outcomes appear comparable with those in adults for the success and complication rates, in the presence of substantial indications, appropriate equipment and adequate experience.
authors.affiliation: Department of Urology, Konya University Meram Medical Faculty, Konya, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Guven
authors.forename: Antonio
authors.initials: A
authors.lastname: Frattini
authors.forename: Bulent
authors.initials: B
authors.lastname: Onal
authors.forename: Mahesh
authors.initials: M
authors.lastname: Desai
authors.forename: Emanuele
authors.initials: E
authors.lastname: Montanari
authors.forename: Jan
authors.initials: J
authors.lastname: Kums
authors.forename: Marco
authors.initials: M
authors.lastname: Garofalo
authors.forename: Jean
authors.initials: J
authors.lastname: de la Rosette
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000002:abnormalities; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000706:statistics & numerical data; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000706:statistics & numerical data*; D061646:Operative Time; D056888:Patient Positioning; D012008:Recurrence; D019233:Retreatment; D016683:Supine Position; D016896:Treatment Outcome; D055815:Young Adult