Yuan Dongbo, Zhang Wei, Zhan Xiong, Su Jiaming, Wang Wei, Luan Boshi, Xiao Shiwei, Chen Weihong, Sun Zhaolin, An Nini, Zhu Jianguo
Guizhou University School of Medicine, Guiyang, China.
Department of Urology, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou Medicine University, Guiyang, China.
Urol Int. 2019;103(1):81-88. doi: 10.1159/000495514. Epub 2019 Apr 30.
To assess the safety of the super-mini percutaneous nephrolithotomy (SMP) versus the minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of pediatric renal calculus.
We retrospectively reviewed the electronic records of pediatric patients who underwent treatment for renal stones by either SMP or MPCNL from May 2015 to May 2016. We compared the safety of the 2 surgical procedures in the treatment of renal calculus in children by using the generalized estimating equation (GEE) multivariate regression analysis, in which the exposures are the surgical procedures and postoperative adverse events (postoperative complications, fever, and WBC counts) are set as outcome variables.
The study included 39 patients (26 boys and 13 girls), of which 22 underwent MPCNL and 17 underwent SMP, with a mean age of 110.05 ± 45.01 and 93.18 ± 41.72 months, respectively. In the univariate logistic regression model, the surgical procedures showed no significant association with postoperative complications (95% CI 0.0-1.5), fever (95% CI 0.1-2.1), postoperative peripheral WBC (95% CI 0.1-2.2). In the multiple logistic regression analysis, there was an insignificant association between surgical methods and postoperative complications (95% CI 0.28-1.1), fever (95% CI 0.1-1.2), and postoperative peripheral WBC (95% CI 0.03-1.8). While using GEE with multiple dependent variables and MPCNL as a reference, the OR of adverse events was 0.15 and the 95% CI were 0.04-0.55.
Compared to MPCNL, SMP has a lower incidence of postoperative complications and appears to be a safer treatment for children with kidney stones.
评估超微通道经皮肾镜取石术（SMP）与微创经皮肾镜取石术（MPCNL）治疗小儿肾结石的安全性。
回顾性分析2015年5月至2016年5月期间接受SMP或MPCNL治疗肾结石的小儿患者的电子病历。我们使用广义估计方程（GEE）多变量回归分析比较了两种手术方法治疗小儿肾结石的安全性，其中暴露因素为手术方法，术后不良事件（术后并发症、发热和白细胞计数）作为结局变量。
该研究纳入39例患者（26例男孩和13例女孩），其中22例行MPCNL，17例行SMP，平均年龄分别为110.05±45.01个月和93.18±41.72个月。在单因素逻辑回归模型中，手术方法与术后并发症（95%CI 0.0 - 1.5）、发热（95%CI 0.1 - 2.1）、术后外周血白细胞（95%CI 0.1 - 2.2）无显著相关性。在多因素逻辑回归分析中，手术方法与术后并发症（95%CI 0.28 - 1.1）、发热（95%CI 0.1 - 1.2）和术后外周血白细胞（95%CI 0.03 - 1.8）之间无显著相关性。以MPCNL为对照，采用具有多个因变量的GEE分析时，不良事件的OR为0.15，95%CI为0.04 - 0.55。
与MPCNL相比，SMP术后并发症发生率较低，似乎是治疗小儿肾结石更安全的方法。
