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经皮肾镜取石术对于3岁以下婴幼儿高效且安全。

Percutaneous nephrolithotomy is highly efficient and safe in infants and children under 3 years of age.

作者信息

Guven Selcuk, Istanbulluoglu Okan, Ozturk Ahmet, Ozturk Bulent, Piskin Mesut, Cicek Tufan, Kilinc Mehmet, Ozkardes Hakan, Arslan Mehmet

机构信息

Selcuk University Meram Medical School, Akyokus Konya, Turkey.

出版信息

Urol Int. 2010;85(4):455-60. doi: 10.1159/000316077. Epub 2010 Sep 10.

Abstract

OBJECTIVE

We aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy (PNL) in infants and small children (12-36 months).

METHODS

The PNL applications conducted in children <3 years of age in two centers were evaluated. Whereas pediatric PNL instrumentation was used in the first center, adult-size instrumentation was utilized in the second center. The complications were given according to the modified Clavien classification system.

RESULTS

The mean age of the patients was 22.76 months (5-36 months) and the mean body weight was 11.51 kg (6-15 kg). In twelve renal units, pediatric instrumentation was used and among these, two had miniperc. In the other eight renal units, adult-size instrumentation was employed. Except for the patient with complex renal stones, all patients were stone free after the intervention and none required a conversion to open surgery. There were grade 1-2 complications in 3 patients. The postoperative hemoglobin drop was greater in the children who underwent PNL with adult-size instrumentation.

CONCLUSION

In this young age group, in addition to standard PNL, simultaneous bilateral PNL, tubeless PNL and in urgent cases of renal failure, urgent PNL, are safe and effective treatment modalities provided patients are selected properly and the surgeon performing the procedure has the necessary experience.

摘要

目的

我们旨在评估经皮肾镜取石术(PNL)在婴幼儿(12 - 36个月)中的疗效和安全性。

方法

对两个中心3岁以下儿童进行的PNL应用进行评估。第一个中心使用儿科PNL器械,第二个中心使用成人尺寸的器械。并发症根据改良的Clavien分类系统给出。

结果

患者的平均年龄为22.76个月(5 - 36个月),平均体重为11.51千克(6 - 15千克)。在12个肾单位中,使用了儿科器械,其中2个进行了微通道经皮肾镜取石术(miniperc)。在其他8个肾单位中,使用了成人尺寸的器械。除了患有复杂肾结石的患者外,所有患者干预后结石清除,无一例需要转为开放手术。3例患者出现1 - 2级并发症。使用成人尺寸器械进行PNL的儿童术后血红蛋白下降更大。

结论

在这个低龄组中,除了标准PNL外,同期双侧PNL、无管PNL以及在肾衰竭的紧急情况下,紧急PNL,只要患者选择得当且实施手术的外科医生有必要的经验,都是安全有效的治疗方式。

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