TY  - EJOU
AU  - Zhang, Caixiang 
AU  - Wang, Xiaochuan 
AU  - Zhao, Youquan 
AU  - Zhou, Houyu 
AU  - Islam, Kahriman 
AU  - Batur, Jesur 
AU  - Li, Jun 

TI  - Comparison of efficacy and safety between bilateral single-session PCNL and bilateral staged PCNL in preschool children
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  -  <b>Objective:</b> Bilateral kidney stones in preschool children are challenging to manage, and the optimal surgical strategy remains unclear. This study aimed to compare the efficacy and safety of bilateral single-session percutaneous nephrolithotomy (PCNL) and bilateral staged PCNL in preschool children with bilateral kidney stones. <b>Methods:</b> We retrospectively reviewed preschool children aged &lt;7 years with bilateral kidney stones who underwent PCNL at our two centers between June 2014 and June 2025. Patients were divided into a bilateral staged PCNL group and a bilateral single-session PCNL group. Perioperative outcomes, stone-free rate (SFR), and complication rate (CR) were compared, and logistic regression analyses were performed to identify factors associated with SFR and CR. <b>Results:</b> No significant difference in SFR (per renal unit) was observed between the bilateral single-session PCNL group and the bilateral staged PCNL group (87.18% vs. 72.92%, <i>p</i> = 0.232). CR (per person) was also comparable between the two groups (43.59% vs. 33.33%, <i>p</i> = 0.419), and all recorded complications were low-grade and manageable, corresponding to Clavien-Dindo Grades I-II. Multivariable logistic regression analysis showed that bilateral single-session PCNL was independently associated with a higher SFR compared with bilateral staged PCNL (odds ratio [OR]: 11.75; 95% confidence interval [CI]: 1.62–85.15; <i>p</i> = 0.015). Tract size &gt;4.8 Fr was also independently associated with a higher SFR (OR: 5.73; 95% CI: 1.01–32.61; <i>p</i> = 0.049). No evaluated variable was significantly associated with CR. <b>Conclusion:</b> Bilateral single-session PCNL is an effective therapeutic strategy for the management of preschool children with bilateral kidney stones, providing stone-free outcomes and complication rates comparable to those of bilateral staged PCNL.
KW  - kidney stones; children; percutaneous nephrolithotomy; stone-free rate; complications

DO  - 10.32604/cju.2026.083925