title: Minipercutaneous nephrolithotomy in infants: a single-center experience in an endemic region in Turkey.
abstract: The objective of the study is to evaluate the effectiveness and safety of miniaturized percutaneous nephrolithotomy (mini-PNL) method in infantile patients <3 years of age diagnosed with renal stones. We studied 48 renal units in 40 patients of infantile patients <3 years of age who underwent mini-PCNL at our institute. The mean age of the patients was 24.02 (5-36) months. The mean diameter of the stones was 22.3 mm (11-45 mm). Intrarenal access was achieved under fluoroscopic (n = 43) or ultrasonographic (n = 5) guidance under general anesthesia. A 20 Fr peel-away sheath, a 17 Fr rigid nephroscope and a pneumatic intracorporeal lithotripsy were used. Mean operative time for PNL was 85 (25-135) min. Mean fluoroscopy time was estimated as 3.7 min. The mean hospital stay was 4.3 days (2-10). Mean hemoglobin loss was 0.89 g/L (11.56-10.67) and three of the patients, including one case during the perioperative period, required blood transfusions. Colonic perforation developed in one case. In two patients, urinary drainage persisted for more than 24 h after withdrawal of the nephrostomy tube. Seven patients developed urinary tract infections (UTI). At the end of the postoperative first week, the stone-free rate was estimated to be 81.2 %. In conclusion, for percutaneous management of renal stones in the infantile age group, mini-PNL is an applicable treatment modality that can be applied through small incisions. It has higher stone-free rates, shorter hospital stays, and excellent esthetic outcomes. In this age group especially, surgical exposure to hypothermia and radiation should be avoided.
authors.affiliation: Medical Faculty, Department of Urology, Dicle University, Diyarbakir, Turkey.
authors.forename: Mehmet Nuri
authors.initials: MN
authors.lastname: Bodakci
authors.forename: Mansur
authors.initials: M
authors.lastname: Daggülli
authors.forename: Ahmet Ali
authors.initials: AA
authors.lastname: Sancaktutar
authors.forename: Haluk
authors.initials: H
authors.lastname: Söylemez
authors.forename: Namık Kemal
authors.initials: NK
authors.lastname: Hatipoglu
authors.forename: Mehmet Mazhar
authors.initials: MM
authors.lastname: Utangaç
authors.forename: Necmettin
authors.initials: N
authors.lastname: Penbegül
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ziypak
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Bozkurt
mesh_terms: D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011446:Prospective Studies; D014421:Turkey / Q000453:epidemiology