This study is designed to compare two surgical techniques for removing kidney stones in children and adolescents (ages 6-18 years). Both methods are types of percutaneous nephrolithotomy (PCNL), a standard procedure for kidney stones larger than 10 mm. In the traditional method, a temporary tube (nephrostomy tube) is left in the kidney after surgery to drain urine. In the newer "tubeless" method, the tube is not used, and only a small internal stent may be placed. We want to find out if the tubeless method is as safe and effective as the traditional method, and whether it reduces pain, hospital stay, and the need for blood transfusions. The study involves 640 patients at Khyber Teaching Hospital in Peshawar, Pakistan. Each participant is randomly assigned to one of the two techniques.
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Length of hospital stay (days)
Timeframe: From surgery to discharge (up to 7 days).
Operative time (minutes)
Timeframe: During surgery (single procedure).
Blood transfusion requirement (%)
Timeframe: surgery through hospital discharge (up to 7 days).
Stone-free status (%)
Timeframe: At hospital discharge (within 48 hours after surgery).