Introduction Percutaneous nephrolithotomy (PNL) is the treatment of choice in children with complex and large stones. With the experience gained from adult practice, supine PNL is increasingly performed in children as well. We aimed to evaluate the comparative results of prone and supine mini-PNL (m-PNL) performed for large/complex stones in children. Patients and methods The study included children who underwent supine and prone m-PNL at two centers between September 2019-2022. Patients were divided into two groups with a 1:1 ratio to index supine m-PNL and prone m-PNL cases for the size, number, location of the stones, degree of hydronephrosis and age. Operative related parameters, success and complication rates are being discussed on a procedure based manner. Results Fourty-two patients (21 supine, 21 prone) were included. The mean age was 9,6±4 years, mean stone size was 28,8±13,6 mm. Regarding the operative data, while the mean duration of procedure time was 65,7±17,8 min in supine group, 86,9±19,0 min in prone group (p=0,001). Fluoroscopy time was shorter in supine group (p=0,027). While tubeless PNL was performed in 11 cases of prone group (52%) , this number was 18 (86,7%) in supine group (p=0,019). Stone-free rates were similar in both groups (supine m-PNL:90,5%, prone m-PNL:85,7%, p=0.634). Complications were minor in nature in the majority of the cases of both groups which resolved with supportive measures in a short period of time. However, there was a statistically significant difference regarding the location and number accesses between two groups (p=0,008). Simultaneous flexible URS was performed in 8 patients in the supine PNL group (<0,001). Conclusions Our current findings and the highly limited data reported in the literature indicate that as an established minimal invasive treatment alternative m-PNL procedure in supine position can also be performed with similar success and complication rates in pediatric population.

中文翻译：

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通过倾向匹配分析比较两个中心在小儿仰卧位和俯卧位小型经皮肾镜取石术方面的经验。

简介 经皮肾镜取石术 (PNL) 是患有复杂和大结石的儿童的首选治疗方法。随着从成人实践中获得的经验，仰卧 PNL 也越来越多地在儿童中进行。我们的目的是评估针对儿童大/复杂结石进行俯卧位和仰卧位迷你 PNL (m-PNL) 的比较结果。患者和方法 该研究包括 2019 年 9 月至 2022 年期间在两个中心接受仰卧位和俯卧位 m-PNL 的儿童。根据结石的大小、数量、位置、肾积水程度和年龄，将患者按 1:1 的比例分为卧位 m-PNL 和俯卧位 m-PNL 病例两组。手术相关参数、成功率和并发症率正在基于手术的方式进行讨论。结果 纳入 42 名患者（21 名仰卧位，21 名俯卧位）。平均年龄为 9.6±4 岁，平均结石尺寸为 28.8±13.6 毫米。关于手术数据，仰卧组的平均手术时间为 65,7±17,8 分钟，俯卧组为 86,9±19,0 分钟（p=0,001）。仰卧组透视时间较短 (p=0,027)。俯卧组有 11 例 (52%) 进行了无管 PNL，而仰卧组则有 18 例 (86.7%) (p=0.019)。两组的无结石率相似（仰卧位 m-PNL：90.5%，俯卧位 m-PNL：85.7%，p=0.634）。两组病例中的大多数病例的并发症性质都很轻微，可以在短时间内通过支持措施得到解决。然而，两组之间的访问位置和次数存在统计学显着差异 (p=0,008)。仰卧 PNL 组的 8 名患者同时进行了柔性 URS (<0,001)。结论 我们目前的研究结果和文献中报告的非常有限的数据表明，作为一种既定的微创治疗替代方法，仰卧位 m-PNL 手术也可以在儿科人群中获得相似的成功率和并发症发生率。