Impact of Previous Stone Treatment on the Outcomes of Percutaneous Nephrolithotomy in Children with Renal Stones

Objective: In this single center study, we aimed to compare perioperative outcomes of PCNL in pediatric patients with and without history of previous stone treatments including open renal stone surgery, PCNL, and shockwave lithotripsy (SWL). Material and Methods: We retrospectively evaluated children under 18 years of age who underwent PCNL operation between 2008 and 2016 in our clinic. Cases were further divided into two groups: patients with a history of open renal surgery or PCNL or failed SWL on the same side were categorized as group 1, primary PCNL patients were categorized as group 2. Demographic data, preoperative and operative data were compared between the selected two groups. We used kidney-ureter-bladder radiography (non-contrast-enhanced computed tomography in cases with non-opaque stones) that performed 6 weeks postoperatively for the assessment of residual stones (≥4mm). Postoperative complications were recorded according to modified Clavien classification. Residual stone rates and complications of PCNL were compared between the two groups. Results: The study included 122 PCNL cases with mean±SD age of 7.14±4.86 years. 35 of the 122 PNL cases (28.69%) had a history of previous stone treatment for the same side kidney stone. There was no statistically significant difference between the two groups in terms of change in hemoglobin values (p=0.997), operation time (p=0.584) and hospital stay (p=0.997). No statistically significant difference was found the residual stone rates (p=0.365) and postoperative com- plications (p=0.886), as well. No statistically significant differences were found between the groups for the rates of residual stones (p=0.365) and postoperative complications (p=0.886), as well. Conclusion: The results of this study demonstrate that PCNL can be safely performed in children with previous stone treatment