Desoky Esam A E, ElSayed Ehab R, Eliwa Ahmed, Sleem Mohamed, Shabana Waleed, Dawood Tamer, Teleb Mohamed, Khalil Salem
Department of Urology, Zagazig University, Zagazig, Sharkia, Egypt.
Department of Urology, Zagazig University, Zagazig, Sharkia, Egypt.
Urology. 2015 May;85(5):1162-1165. doi: 10.1016/j.urology.2015.01.030. Epub 2015 Mar 17.
To evaluate the safety and efficacy of pediatric percutaneous nephrolithotomy (PCNL) in the flank-free modified supine position (FFMSP). PCNL in the supine position is increasingly and successfully used in pediatric age group. Different modifications of supine positions have been described; however, the best supine position is not well established and remains a matter of debate.
This prospective study included 22 children presenting with single renal pelvis stone (2-3 cm) in the period between May 2012 and April 2014. Diagnosis was set by plain x-ray and computed tomography in all patients. PCNL was performed with the patients placed in the FFMSP. The operative time and hospital stay were estimated. The outcome and any perioperative complications or conflicts were recorded.
The study included 22 children (15 boys and 7 girls) with a solitary renal pelvis stone. Mean ± standard deviation age of the patients was 9.5 ± 3.2 years (range, 3-15.5 years). Stone length, operative time, and hospital stay had mean ± standard deviation of 2.4 ± 0.23 cm, 65.1 ± 18.7 minutes, and 4.4 ± 0.9 days. Stone-free rate was 90.9% after 1 session of PCNL. One patient (4.5%) needed a second-look PCNL. Shock wave lithotripsy was performed for another patient. Postoperative fever occurred in 4 patients (18.2%). One patient received postoperative blood transfusion. Postoperative transient urinoma occurred in 2 patients (9.1%).
PCNL in pediatric age group via FFMSP was proved to be safe and effective in management of renal pelvis stones of size 2-3 cm. It provides stone clearance rate comparable with that reported of conventional PCNL in the prone position.
评估小儿经皮肾镜取石术（PCNL）在无肋弓改良仰卧位（FFMSP）下的安全性和有效性。仰卧位PCNL在小儿年龄组中越来越多地被成功应用。已经描述了仰卧位的不同改良方式；然而，最佳仰卧位尚未明确确立，仍是一个有争议的问题。
这项前瞻性研究纳入了2012年5月至2014年4月期间22例患有单个肾盂结石（2 - 3厘米）的儿童。所有患者均通过腹部平片和计算机断层扫描进行诊断。PCNL在患者处于FFMSP时进行。估计手术时间和住院时间。记录结果以及任何围手术期并发症或不良事件。
该研究纳入了22例患有孤立性肾盂结石的儿童（15例男孩和7例女孩）。患者的平均年龄±标准差为9.5±3.2岁（范围为3 - 15.5岁）。结石长度、手术时间和住院时间的平均值±标准差分别为2.4±0.23厘米、65.1±18.7分钟和4.4±0.9天。单次PCNL术后结石清除率为90.9%。1例患者（4.5%）需要二期PCNL。另1例患者接受了体外冲击波碎石术。4例患者（18.2%）术后发热。1例患者接受了术后输血。2例患者（9.1%）出现术后短暂尿囊肿。
经FFMSP进行的小儿PCNL被证明在处理2 - 3厘米大小的肾盂结石时是安全有效的。其结石清除率与传统俯卧位PCNL报道的相当。
