title: Reliability of percutaneous nephrolithotomy in pediatric patients: comparison of complications with those in adults.
abstract: OBJECTIVE
  To assess the reliability of percutaneous nephrolithotomy (PNL) in pediatric patients by comparing complications between pediatric patients and adults by use of the modified Clavien grading system.
  
  
  METHODS
  The data of 74 pediatric (0 to 16 years) and 535 adult (17 years and older) patients who underwent PNL owing to kidney stone disease between January 2005 and December 2011 were analyzed retrospectively. The complications in the pediatric and adult patients were classified in five grades according to the modified Clavien system.
  
  
  RESULTS
  The most frequent cause of grade I complications was fever requiring antipyretics, which was seen in 4 pediatric patients (5.4%) and 30 adult patients (5.6%). Grade II complications (blood transfusions, <12 hours urinary leakage) were observed in 11 pediatric patients (14.8%) and 80 adult patients (14.9%). Grade III complications were also seen in 6 pediatric patients (8.1%) (grade IIIb; D-J catheter implantation under general anesthesia) and 78 adult patients (14.5%) (grade IIIa; D-J catheter implantation and angio-embolization under local anesthesia). There was no statistically significant difference between the two groups in terms of grade I, II, or III complications (p>0.05). Colonic injury occured in one patient (1.3%) in the pediatric group (grade IVa). In the adult group, one patient (0.2%) died as the result of myocardial infarction (grade V).
  
  
  CONCLUSIONS
  Thanks to technological developments and minimalization of the equipment used, when indicated, pediatric patients can be safely treated with PNL with low complication rates similar to those in adult patients.
authors.affiliation: Department of Urology, University of Gaziantep School of Medicine, Gaziantep, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Bayrak
authors.forename: Sakip
authors.initials: S
authors.lastname: Erturhan
authors.forename: Ilker
authors.initials: I
authors.lastname: Seckiner
authors.forename: Muharrem
authors.initials: M
authors.lastname: Baturu
authors.forename: Ismail
authors.initials: I
authors.lastname: Basmaci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Erbagci
keywords: Complications; Nephrolithiasis; Percutaneous nephrolithotomy