Ultrasound-guided minimally invasive percutaneous nephrolithotomy in the treatment of pediatric patients <6 years: A single-center 10 years’ experience

Owing to the fragile kidney and relative small collecting system of pediatric patients, urologists were always reluctant to treat pediatric urolithiasis with PCNL. Here we conduct a study to assess the effectiveness and safety of pediatric patients with renal calculi <6 years. A total of 88 pediatric patients (99 kidney units) <6 years underwent the ultrasound (US)-guided minimally invasive percutaneous nephrolithotomy in our institute from March 2006 to April 2016. The mean age was 30.9 months (range, 7–72 months). The mean stone size was 19.5 mm (range, 10–50 mm). The group included single stone in 35 kidney units, upper ureteral stone in 12 kidney units, multiple stone in 43 kidney units, and staghorn stone in 9 kidney units. The procedure of puncture and dilation were guided by US solely. The mean operation time was 52.3 minutes (range, 15–140 minutes). The mean postoperative length of stay was 6.0 days (3–16 days). Besides, the initial stone free rate (SFR) was 90.9% (90/99) and the final SFR was 96.0% (95/99). The mean hemoglobin drop was 10.9 g/L (range, 1–25 g/L). Postoperative complications occurred in 12 patients including fever in 11 cases and active pleural effusion in 1 case. The US-guided MPCNL is an effective and safety procedure to treat pediatric patients with stone <6 years.