title: Percutaneous Nephrolithotomy in Children: 17 Years of Experience.
abstract: We analyzed factors that might affect outcome in terms of success and incidence of complications in children up to 17 years after undergoing percutaneous nephrolithotomy.
  
  
  
  The data of 346 renal units (294 patients) were analyzed in terms of postoperative outcome. Factors investigated that might affect outcome were patient gender, age, stone laterality, largest stone size, stone burden, number of stones, location of a single stone, previous intervention and instrument size.
  
  
  
  Mean ± SD patient age was 8.51 ± 4.91 years, and male-to-female ratio was 209:137. Mean ± SD stone burden was 3.49 ± 3.3 cm(2). Stone-free rates after a single procedure were 84.4% and 73.1% in patients with and without clinically insignificant residual stones, respectively. On univariate and multivariate analyses stone burden and number of stones affected the stone-free rate. Complications consisted of bleeding in 41 patients (11.8%), postoperative urinary tract infection in 21 (6%), urosepsis in 4 (0.1%) and hydrothorax in 4 (0.1%). One patient died of multiple organ failure. Through the years blood transfusion and complication rates decreased, and the use of smaller instruments increased significantly. Although bleeding occurred less often in cases where a 14Fr sheath was used rather than a larger sheath (5% vs 12%, p = 0.142), the difference was not significant. No significant factor affecting complication rates was detected.
  
  
  
  As in adults, percutaneous nephrolithotomy can be used in children with acceptable complication rates and good success rates for surgical treatment of complex renal stones. Number of stones and stone burden are predictive of postoperative stone-free rate.
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Çıtamak
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Altan
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: A C
authors.initials: AC
authors.lastname: Bozacı
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Koni
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: H S
authors.initials: HS
authors.lastname: Doğan
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: C Y
authors.initials: CY
authors.lastname: Bilen
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Şahin
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Urology, Acıbadem University Faculty of Medicine, Istanbul (AS), Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Tekgül
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000601:surgery; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D000074642:Nephrolithotomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: kidney calculi; lithotripsy; nephrostomy, percutaneous; pediatrics