Singh Dongol Udaya Man, Limbu Yugal
Department of Urosurgery, Kathmandu Medical College and Teaching Hospital, Kathmandu.
J Nepal Health Res Counc. 2017 Sep 8;15(2):130-134. doi: 10.3126/jnhrc.v15i2.18192.
Renal stone disease is a common problem in children in developing countries. Its prevalence in children varies from 5% to 15%. It is suggested that anatomic abnormalities, recurrent urinary tract infections, metabolic disturbances, dietary and environmental factors are the predisposing factors.The aim of this study is to evaluate the safety and efficacy of percutaneous nephrolithotomy in children.
Between May 2012 and Dec 2016, 25 children with renal stone diseases underwent percutaneous nephrolithotomy and were evaluated for stone free rate, complications, blood transfusion rate, sandwich therapy, etc.
The mean age of children was 9.3 years (7-15 years) and the mean size of the stone was 20 mm (13-27 mm). The anatomical location of stone was important in terms of stone clearance. Three patients needed blood transfusion. The overall stone free rate was 88% before discharge. Three patients had residual stones and were treated with extracorporeal shockwave lithotripsy. Complications included fever, haematuria, ileus and urine leak. No major complications were noted. There were no significant differences in haemoglobin and creatinine levels before and 12 hours after the surgery.
Percutaneous nephrolithotomy (PCNL) can be considered a safe, effective and feasible modality of treatment for children with an average of 2 cm sized renal stones.
肾结石病在发展中国家儿童中是一个常见问题。其在儿童中的患病率为5%至15%。解剖学异常、复发性尿路感染、代谢紊乱、饮食和环境因素被认为是诱发因素。本研究的目的是评估经皮肾镜取石术治疗儿童肾结石的安全性和有效性。
2012年5月至2016年12月期间，25例患有肾结石病的儿童接受了经皮肾镜取石术，并对结石清除率、并发症、输血率、三明治疗法等进行了评估。
儿童的平均年龄为9.3岁（7至15岁），结石的平均大小为20毫米（13至27毫米）。结石的解剖位置对结石清除很重要。3例患者需要输血。出院前的总体结石清除率为88%。3例患者有残余结石，接受了体外冲击波碎石术治疗。并发症包括发热、血尿、肠梗阻和尿漏。未发现重大并发症。手术前和手术后12小时血红蛋白和肌酐水平无显著差异。
经皮肾镜取石术（PCNL）可被认为是治疗平均结石大小为2厘米的儿童肾结石的一种安全、有效且可行的治疗方式。
