Jabrayilov Hikmat, Koparal Murat Yavuz, Gürocak Serhat, Küpeli Bora, Tan Mustafa Özgür
Urology Clinic, Medical Park Ankara Hospital, Ankara 06370 Turkey.
Department of Urology, Recep Tayyip Erdogan University Training and Research Hospital, Rize 53020, Turkey.
J Clin Med. 2018 Mar 4;7(3):43. doi: 10.3390/jcm7030043.
In this study, we aimed to determine factors affecting the success rate of percutaneous nephrolithotomy (PNL) in children. The series consisted of 41 consecutive children operated on by the same surgical team for renal calculi with PNL between June 2002 and May 2015 in our institution. A single calyx or pelvic stone was described as simple, while calculi located in more than one location (calyx and pelvis or more than one calices) or staghorn stones were described as complex. The procedure was deemed successful if the patient was completely stone-free (SF) or had residual fragments <4 mm. Thirty-four patients were found to be SF or had residual fragments <4 mm on the postoperative first day, thus the success rate was 82.9%. In complex stones, the success rate was significantly lower (45.5%) than simple stones (96.7%) ( < 0.001). The grade of hydronephrosis (Grade 0-1 vs. Grade 2-3) also had a negative impact on the success, with rates of 92.6% vs. 64.3%, respectively ( = 0.022). Previous urological procedure history on the same side yielded a success rate of 58.3%, whereas the success rate in the primary patients was 93.1% ( < 0.001). The localization of the stone (complex vs. simple), degree of hydronephrosis, and history of previous urological procedures were found to be the factors that affected the success of the paediatric PNL.
在本研究中,我们旨在确定影响儿童经皮肾镜取石术(PNL)成功率的因素。该系列研究包括2002年6月至2015年5月期间在我们机构由同一手术团队为肾结石患儿进行PNL手术的41例连续病例。单个肾盏或肾盂结石被描述为简单结石,而位于一个以上部位(肾盏和肾盂或多个肾盏)的结石或鹿角形结石被描述为复杂结石。如果患者结石完全清除(SF)或残留碎片<4mm,则该手术被视为成功。34例患者在术后第一天被发现结石完全清除或残留碎片<4mm,因此成功率为82.9%。在复杂结石中,成功率(45.5%)显著低于简单结石(96.7%)(<0.001)。肾积水程度(0-1级与2-3级)也对成功率有负面影响,成功率分别为92.6%和64.3%(=0.022)。同侧既往泌尿外科手术史的成功率为58.3%,而初治患者的成功率为93.1%(<0.001)。结石的定位(复杂与简单)、肾积水程度和既往泌尿外科手术史被发现是影响儿童PNL手术成功的因素。