title: Paediatric percutaneous nephrolithotomy: single-centre 10-year experience.
abstract: BACKGROUND
  Percutaneous nephrolithotomy (PCNL) is a standard management option for complex and large renal calculi. In children, there is some concern over potential perioperative complications. We reviewed our 10 years of experience of PCNL in children and present our data.
  
  
  METHODS
  Data for paediatric patients who underwent PCNL at our centre in the last decade were retrieved. PCNL was performed in standard prone position under fluoroscopic guidance. Patient characteristics, outcomes and complications were reviewed. Complications were graded according to the modified Clavien system. A comparison was also made between supracostal and infracostal accesses.
  
  
  RESULTS
  95 children underwent PCNL in our institute in the last decade. 7 patients had bilateral PCNL. The most common presentation was flank pain (85%). 83% patients were stone-free after first PCNL and overall 94% were stone free after second-look PCNL and auxillary procedures. 6 cases had clinically insignificant residual fragments. Supracostal puncture was performed in 32 cases. Complications were higher in the supracostal puncture group (16 (50%)) and included fever in 11, sepsis in 2 and hydrothorax in 3 patients. There were 7 (10%) complications in the infracostal group: fever in 5 and perinephric collection in 2 patients. 16 patients had grade 1, 9 had grade 2 and another 2 cases developed grade 3 complications.
  
  
  CONCLUSIONS
  PCNL is a safe and effective procedure in children. It enables excellent stone clearance with minimal number of interventions.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Bhageria
authors.forename: Brusabhanu
authors.initials: B
authors.lastname: Nayak
authors.forename: Amlesh
authors.initials: A
authors.lastname: Seth
authors.forename: Prem Nath
authors.initials: PN
authors.lastname: Dogra
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006876:Hydrothorax / Q000628:therapy; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D018805:Sepsis / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome