Department of Urology, Kecioren Training and Research Hospital, Ankara, Turkey.
Urology. 2010 Jul;76(1):247-52. doi: 10.1016/j.urology.2009.08.087.
To compare the morbidity and success rates among different age groups of children undergoing percutaneous nephrolithotomy (PCNL) using adult- or pediatric-sized devices. PCNL for renal stones in children may present problems because of small size, mobility of the pediatric kidney, and the small size of the collecting system.
Patients were categorized into 2 age groups: those < or =7 years old at the time of PCNL (group 1, n = 17 [38.6%]), and those 8-16 years old (group 2, n = 27 [61.4%]). Group 2 children were further divided into subgroups according to the use of pediatric- (group 2a, n = 12 [27.3%]) or adult-sized devices (group 2 b, n = 15 [34.1%]).
Mean patient age was 4.1, 11.7, and 13.2 years in groups 1, 2a, and 2b, respectively. Fluoroscopy time, time to access the collecting system, operative time, and average postoperative hospital stay did not differ between the groups. However, hemoglobin decrease, bleeding during surgery, and blood transfusion rate was higher in group 2b. Stones were completely cleared in 82.4%, 83.3%, and 81.3% patients, and these percentages increased to 94.1%, 91.7%, and 93.7% with adjunctive shock wave lithotripsy and ureterorenoscopy in groups 1, 2a, and 2b, respectively.
Endourologic intervention in children usually requires instruments specific for preschool age; however, in older children with dilated collecting system, the use of adult instruments and techniques may achieve equal results.
比较经皮肾镜碎石术（PCNL）中使用成人或小儿尺寸设备在不同年龄组儿童中的发病率和成功率。儿童肾结石的 PCNL 可能会因为肾脏小、儿童肾脏活动度大以及集合系统小而出现问题。
将患者分为 2 个年龄组：PCNL 时年龄<或=7 岁（第 1 组，n=17 [38.6%]）和 8-16 岁（第 2 组，n=27 [61.4%]）。第 2 组儿童根据使用小儿（第 2a 组，n=12 [27.3%]）或成人尺寸设备（第 2b 组，n=15 [34.1%]）进一步分组。
第 1、2a 和 2b 组患者的平均年龄分别为 4.1、11.7 和 13.2 岁。透视时间、进入集合系统的时间、手术时间和平均术后住院时间在各组之间无差异。然而，第 2b 组的血红蛋白下降、术中出血和输血率较高。结石完全清除率在第 1、2a 和 2b 组分别为 82.4%、83.3%和 81.3%，在附加冲击波碎石术和输尿管镜检查后分别增加至 94.1%、91.7%和 93.7%。
儿童的腔内介入治疗通常需要特定于学龄前儿童的器械；然而，对于具有扩张集合系统的较大儿童，使用成人器械和技术可能会达到相同的效果。
