Evaluation of Pediatric Percutaneous Nephrolithotomy Experience of an Adult-Trained Surgeon

Abstract

Purpose:

The aim of our study is to evaluate the pediatric percutaneous nephrolithomy (PCNL) learning curve of a surgeon.

Patients and Methods:

The cases of the first 70 pediatric patients with renal stone disease who underwent PCNL by a surgeon who had performed 120 PCNLs on adults at our clinic were analyzed retrospectively. The patients were divided into two groups depending on their date of surgery (n=35), and the localization of the stone, stone burden, access numbers on the kidney, stone-free rates, blood transfusion in the perioperative-postoperative period, duration of hospitalization, and complications were recorded.

Results:

The mean of patients in group 1 was 11.45±3.93 (2–16) years, while the same value for group 2 was 8.42±4.21 (1–16) years (P<0.005). There was no statistically significant difference between the two groups regarding stone surface area (group 1: 332.57±192.46 [100–700] mm²; group 2: 322.85±165.20 [150–900] mm²), number of access, stone localization, duration of hospitalization, duration of surgery, blood replacement, and Double-J implantation (P>0.005). While the stone-free rate was 82.85% for group 1, it was 100% for group 2 (P>0.005).

Conclusions:

Pediatric PCNL can be performed safely after 120 adult PCNL procedures, although this number varies from one surgeon to another. After the first 35 pediatric PCNL experiences, PCNL can safely be performed even on very young children, and higher stone-free rates can be obtained.