Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Urolithiasis. 2017 Aug;45(4):393-399. doi: 10.1007/s00240-016-0920-7. Epub 2016 Sep 15.
To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (<15 years) of bilateral staghorn calculi from 2004 to 2015. Staged PCNL was done after 2-3 days if needed and opposite side PCNL was performed after 10-14 days. Fifty-one patients with bilateral staghorn renal calculi underwent PCNL. The mean age of the study group was 10.25 ± 2.13 (range 3-15). Mean stone burden was 778.3 + 613.4 (range 231-3850 mm). Forty-five patients underwent single puncture, twenty-two patients underwent double punctures whereas six patients underwent triple punctures during first session PCNL procedure. Most common puncture location was through the superior calyx (58.82 %). The mean operating time was 77.25 + 30.21 (range 58-145). After the first session PCNL, the success rate was 76.47 %. Thirteen patients (17 renal units) underwent relook PCNL and seven patients underwent ESWL. Overall complication noted in twenty-four (47.05 %) cases. Most of the complications were minor grade. Percutaneous nephrolithotomy for staghorn calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.
为了评估儿童双侧鹿角状结石经皮肾镜取石术（PCNL）的结果，我们进行了回顾性分析。鹿角状结石定义为填满肾盂-肾盏系统大部分的结石。然而，在发展中国家，患者可能会出现鹿角状结石。PCNL 是成人和儿童鹿角状结石的首选治疗方法。我们的研究包括 2004 年至 2015 年间 51 例双侧鹿角状肾结石的儿科患者（<15 岁）。如有需要，在 2-3 天后进行分期 PCNL，在 10-14 天后进行对侧 PCNL。51 例双侧鹿角状肾结石患者行 PCNL。研究组的平均年龄为 10.25 ± 2.13 岁（范围 3-15 岁）。平均结石负荷为 778.3 ± 613.4mm（范围 231-3850mm）。45 例患者行单穿刺，22 例患者行双穿刺，6 例患者行首次 PCNL 时行三穿刺。最常见的穿刺部位是上盏（58.82%）。平均手术时间为 77.25 ± 30.21 分钟（范围 58-145 分钟）。首次 PCNL 后，成功率为 76.47%。13 例（17 个肾单位）行再次 PCNL，7 例行 ESWL。24 例（47.05%）出现总体并发症。大多数并发症为轻微。儿童鹿角状结石的经皮肾镜取石术需要专业知识。儿童双侧鹿角状肾结石的 PCNL 是安全有效的。功能受损的双侧鹿角状肾结石并发出血等并发症的几率更高。
