Sarikaya Selcuk, Ebiloglu Turgay, Selvi Ismail, Faruk Bozkurt Omer, Senocak Cagri
Gulhane Research and Training Hospital. Department of Urology. Ankara. Turkey.
Kecioren Research and Training Hospital. Department of Urology. Ankara. Turkey.
Arch Esp Urol. 2019 Jan;72(1):54-60.
Urinary stone diseaseis less common in pediatric age group and it has anincreasing incidence. In this study, our hypothesis is toevaluate if one of the techniques, PNL or RIRS is superiorthan the other in terms of stone free status (SFR), fluoroscopytime (FT), operation time (OT), complication rate(CR), JJ stent insertion rate, and hospitalization duration(HD) in children.
Between 2013 and 2016, 74 patients(under 18 years- old) were operated for the treatmentof renal stones between 1-2cm size. 37 patientswere male (50%) and 37 of them (50%) were female.The study shows the experience of a single center. Dataof the patients who underwent (surgery) were recorded.
SFR was not different in both groups in shortand long terms follow up, but hgb drop, FT, OT, andHD were detected to be worse in PNL group. Therewas lower complication rates for RIRS group comparing to PCNL group according to Clavien classification butgrade I complications were higher in RIRS group.
Although PNL is a cheaper treatmentmethod, RIRS has less creatinine change, less FT, lessOT, less CR, less HT with similar SFR for 1-2cm renalstones in children. Long term SFR were 83.8% for RIRSand 86.5% for PCNL. RIRS is a treatment of choice inchildren with 1-2 cm renal stones as it has more advantagesbut the costs must be considered.
小儿尿石症在儿科年龄组中不太常见，但其发病率呈上升趋势。在本研究中，我们的假设是评估经皮肾镜取石术（PNL）或逆行肾内手术（RIRS）这两种技术在儿童结石清除状态（SFR）、透视时间（FT）、手术时间（OT）、并发症发生率（CR）、双J管置入率和住院时间（HD）方面是否优于另一种技术。
2013年至2016年期间，74例（18岁以下）患者接受了1 - 2厘米大小肾结石的手术治疗。37例患者为男性（50%），37例（50%）为女性。该研究展示了单一中心的经验。记录了接受（手术）患者的数据。
在短期和长期随访中，两组的结石清除率无差异，但PNL组的血红蛋白下降、透视时间、手术时间和住院时间更差。根据Clavien分类，RIRS组的并发症发生率低于经皮肾镜取石术组，但RIRS组的I级并发症更高。
尽管经皮肾镜取石术是一种成本较低的治疗方法，但对于儿童1 - 2厘米肾结石，逆行肾内手术的肌酐变化更小、透视时间更短、手术时间更短、并发症更少、住院时间更短，且结石清除率相似。逆行肾内手术的长期结石清除率为83.8%，经皮肾镜取石术为86.5%。逆行肾内手术因其具有更多优势，是治疗1 - 2厘米肾结石儿童的首选治疗方法，但必须考虑成本。
