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.

Background: The purpose of surgeries performed for congenital anomalies in children is to increase the survival rates and provide a developmental comparison to that of their peers. Aim: The objective of this study was to investigate the development of children following surgery for congenital anomalies and the risk factors affecting their development. Methods: Our study included 33 children who underwent surgery for gastrointestinal anomalies in our clinic between 2011 and 2016, and did not have any syndrome, chromosomal abnormality, or additional abnormality. Developmental levels were evaluated using the Ages and Stages Questionnaire (ASQ) and the ASQ: Social–Emotional (ASQ: SE) scales adapted for the use on Turkish children. Data on patient history were obtained retrospectively from patient files. Results: The study included 33 patients, including 11 with esophageal atresia, 6 with intestinal atresia, 11 with anorectal malformation, and 5 with Hirschsprung's disease. Developmental delay was found in the ASQ of 72.7% of the patients and the ASQ: SE tool was 27% of the patients. The rate of patients with scores below the threshold from each parameter of ASQ was higher than that of the normal population (p < 0.05). Development delay was detected using the ASQ scale in 100% of those with microcephaly at birth, in 91% of premature infants born between 1500 and 2500 g, and in 83.3% of those with low birth weight to gestational age. Conclusions: In children who underwent surgery due to congenital anomalies, an evaluation through developmental tests, a post-surgical follow-up process, and a referral to the relevant disciplines when necessary may increase the success of surgery as well as increase the life quality of the patient.

Introduction: Ultrasound (US)-guided puncture has the benefits of avoiding radiation and limiting the risk of visceral injury. We aimed to evaluate the results of two different renal access techniques during pediatric supine mini percutaneous nephrolithotomy (smPCNL) in a comparative manner. Patients and Methods: Data obtained from pediatric patients undergoing smPCNL by single surgeon between September 2021 and 2023 were reviewed retrospectively. Children were divided into two groups namely; biplanar 0°−90° fluoroscopy (Group-F) and US−fluoroscopy combined (Group-C). In all cases, preoperative, operative, and postoperative findings were recorded. Success was defined as the determination of either no (complete stone-free status) or < 4 mm residual fragments (CIRF) on US and X-ray (postoperative 3rd month) images. Complications were evaluated according to modified Clavien−Dindo classification. Results: Data of 54 patients with a mean age of 8.6 years (Group-F = 30, Group-C = 24) are reviewed. In addition to the similar success rates in both groups (Group-F = 86.7% Group-C = 87.5% p = 0.928), similar minor complications were noted in the majority of the cases. No child required transfusion and/or angioembolization. Although the fluoroscopy and operation time were lower in Group-C, the difference was not statistically significant. Conclusion: US–fluoroscopy combined access technique can be applied with similar success and complication rates in pediatric smPCNL. Ultimately, as experience is gained, this technique may lower radiation exposure, although this was not observed in the current study.