Dede Onur, Sancaktutar Ahmet Ali, Baş Okan, Dağgüllu Mansur, Utangaç Mazhar, Penbegul Necmettin, Soylemez Haluk, Hatipoglu Namık Kemal, Bodakci Mehmet Nuri, Bozkurt Yaşar, Atar Murat, Dede Gülay
Department of Urology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
Department of Urology, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Urolithiasis. 2016 Apr;44(2):173-7. doi: 10.1007/s00240-015-0807-z. Epub 2015 Jul 25.
This study aimed to investigate the effectiveness and reliability of micro-percutaneous nephrolithotomy (micro-PNL) for the management of kidney stones in pediatric patients. This retrospective study included 24 infants that underwent micro-PNL for renal stones between March 2012 and April 2015. The inclusion criteria included: age younger than 2 years, stone size <20 mm, absence of urinary tract malformations and active infection, and no coagulopathy. Stone-free rates were assessed one month postoperatively by ultrasonography (USG) and kidneys, ureters, bladder (KUB) radiography. Complications were classified according to the Clavien classification system. The mean age of the patients was 15.8 ± 7.8 months (range, 8-23) and the mean stone size was 13.5 ± 3.84 mm. Intra-renal access was achieved using USG in 11 patients and KUB fluoroscopy in 13 patients. The operation time and fluoroscopic screening time were 53.7 ± 10.35 and 1.4 ± 0.9 min, respectively. The mean hospital stay was 2.5 ± 0.8 days, and the mean drop in the hemoglobin level was 0.51 ± 0.34 g/dL. Bleeding requiring blood transfusion was not observed. A ureteral J stent was implanted perioperatively in four patients because of stone burden. Four patients complained of postoperative renal colic (Clavien grade 1) and postoperative fever was observed in two patients. Definitive success rates were as follows: the stone-free rate was 83.3% (n = 20) and residual fragments were observed in four patients.
本研究旨在探讨微通道经皮肾镜取石术（micro-PNL）治疗小儿肾结石的有效性和可靠性。这项回顾性研究纳入了2012年3月至2015年4月期间接受micro-PNL治疗肾结石的24例婴儿。纳入标准包括：年龄小于2岁、结石大小<20 mm、无尿路畸形和活动性感染、无凝血功能障碍。术后1个月通过超声检查（USG）和肾脏、输尿管、膀胱（KUB）X线摄影评估结石清除率。并发症根据Clavien分类系统进行分类。患者的平均年龄为15.8±7.8个月（范围8-23个月），平均结石大小为13.5±3.84 mm。11例患者使用USG建立肾内通道，13例患者使用KUB透视。手术时间和透视筛查时间分别为53.7±10.35分钟和1.4±0.9分钟。平均住院时间为2.5±0.8天，血红蛋白水平平均下降0.51±0.34 g/dL。未观察到需要输血的出血情况。4例患者因结石负荷在围手术期植入输尿管支架。4例患者抱怨术后肾绞痛（Clavien 1级），2例患者出现术后发热。确切成功率如下：结石清除率为83.3%（n = 20），4例患者观察到残留碎片。
