Assesment of factors affecting outcome of Mini-PCNL by single-shot dilatation in Pediatric Patients.

OBJECTIVES

The prevalence of stone disease in children is increasing, necessitating approaches using instruments of more suitable sizes for surgical treatment. We aim to convey our experience with Mini-PCNL.

MATERIALS AND METHODS

We retrospectively analyzed a total of 72 renal units that underwent single-shot dilatation Mini-PCNL(≤ 17.5F) between August 2017 and November 2024. Univariate and multivariate analyses were used to assess the factors for surgical success (no postoperative residual) and complications.

RESULTS

Medians for our cohort were age at surgery was 5.5 years, operation time was 120 min, hospitalization time was 5 days, stone size was 2.04 cm. Overall SFR was 80.6%. We observed complications in 16 patients(%22.2). In univariate analysis; HU < 820, PCNL history, cystine stone, stone burden > 2 cm and stone length > 29 mm were found to be associated with lower success. In the multivariate analysis results, patients with a previous history of PCNL (56% vs 93.6%) (p = 0.005) and patients with a stone burden ≥ 2 cm (68.4% vs 94.1%) (p = 0.021) were found to be associated with less successful results. Univariate analysis revealed no single predictive factor for complication development.

CONCLUSION

Mini-PCNL is a surgical method that can be performed safely in the pediatric age group due to its high stone-free rate. However, it should be kept in mind that the success rates are lower in those with a history of PCNL due to anatomical challenges secondary to previous surgeries and with high stone burden. Patients with cystine stones deserve more effort to make them free of fragments.