title: Percutaneous nephrolithotomy in children: A preliminary report.
abstract: OBJECTIVE
  The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL) in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients.
  
  
  METHODS
  During the period of the month between May 2011 and April 2013, 38 children (47 renal units) underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24).
  
  
  RESULTS
  The median age at presentation was 8-year (range: 3-12). The operative time ranged from 30 to 120 min (median 90). Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3). Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6%) of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1) and were managed conservatively.
  
  
  CONCLUSIONS
  Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Elderwy
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Gadelmoula
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Elgammal
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Osama
authors.affiliation: Department of Surgery, Division of Urology, College of Medicine, King Saud University, Saudi Arabia.
authors.forename: Hamdan
authors.initials: H
authors.lastname: Al-Hazmi
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: H
authors.initials: H
authors.lastname: Hammouda
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Esam
authors.initials: E
authors.lastname: Osman
authors.affiliation: Department of Urology, Division of Pediatric Urology, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Medhat A
authors.initials: MA
authors.lastname: Abdullah
authors.affiliation: Department of Surgery, Division of Urology, College of Medicine, King Saud University, Saudi Arabia.
authors.forename: Khalid Fouda
authors.initials: KF
authors.lastname: Neel
keywords: Nephrolithiasis; pediatric urolithiasis; percutaneous nephrolithotomy; tubeless percutaneous nephrolithotomy