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Objective: The purpose of this study was to compare the results of tubeless percutaneous nephrolithotomy (TPNL) and standard percutaneous nephrolithotomy (SPNL) for the management of nephrolithiasis in children.
Material and methods: The data for 48 patients aged lesser than 18 years who underwent percutaneous nephrolithotomy (PNL) between January 2010 and June 2018 were reviewed retrospectively. The patients were classified into 2 categories depending on tube placement. A total of 21 patients were treated with TPNL and 27 with SPNL technique. The surgical method employed was selected depending on intraoperative complications. The size of the endoscopic instrument (mini/standard) to be used was decided according to the stone burden and surgeon preference.
Results: A complete stone-free rate (SFR) was achieved in 85.7% (n=18) of the TPNL group and 85.2% (n=23) of the SPNL group (p=0.959). In the TPNL group, two patients with clinically significant stones underwent retrograde intrarenal surgery, and one patient with clinically insignificant residual stone remained under follow-up. In the SPNL group, two patients with clinically significant stones underwent repeat mini-PNL surgery, the stones being fragmented with shock wave lithotripsy in one patient, and 1 one patient with insignificant residual stone remained under follow-up. No significant differences were observed in terms of intraoperative and postoperative complications, mean SFRs, or operative and fluoroscopy times. However, a statistically significant difference was observed in lengths of hospital stay (p<0.001).
Conclusion: TPNL is a safe and effective procedure in children. No significant difference was found between TPNL and SPNL in terms of stone clearance; however, patients undergoing TPNL had significantly shorter hospital stays.
Cite this article as: Yıldızhan M, Asil E. Tubeless PNL can safely be applied to selected patients in pediatric stone disease. Turk J Urol 2021; 47(2): 164-9.