Sofimajidpour Heshmatollah, Zarei Bushra, Rasouli Mohammad Aziz, Hosseini Masoumeh
Department of Urology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Clinical Research Development Center, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Urol J. 2020 Mar 16;17(2):139-142. doi: 10.22037/uj.v0i0.5903.
With the invention of miniature devices, it has been advised to apply less aggressive methods for the management of upper urinary tract stones, especially in children. In the recent years, ultra-mini percutaneous nephrolithotomy (UMP) has been used for the treatment of upper urinary tract stones in order to perform surgeries with less complications and more acceptable outcomes. Results reported from different medical centers have been promising.
Twenty-two children aged less than 8 years old with upper urinary stones sized between 10-20 mm underwent UMP. Inclusion criteria was solitary unilateral kidney stone, stone size between 10-20 mm, normal renal function tests, absence of any congenital malformations, and history of previous ESWL failure. Data including age, sex, side of kidney involvement, size of stone, location of stone, duration of surgery, duration of hospitalization, stone composition, need for blood transfusion, damage to adjacent organs, postoperative fever, septicemia after surgery, need for narcotics, further need for a complementary method, stone-free rate, pre and post-operative hemoglobin levels, and urinary leakage from the access tract were extracted from patients' medical files and were recorded.
The mean age (± standard deviation) of children was 5.22 (±1.57) years. Fourteen (63.6%) patients were male. Fifteen (68.2%) renal stones were located in the right kidney, and 82% of patients had pelvis stones. 13 (59%) patients' stones were composed of calcium oxalate. Stone-free rate was 95.5%. In none of the cases urinary leakage, septicemia after surgery, injury to adjacent organs, and need for blood transfusions was reported.
Ultra-mini percutaneous nephrolithotomy is an efficient and safe method for treating urinary stones sized between 10-20 mm in children.
随着微型设备的发明，有人建议对上尿路结石采用侵入性较小的治疗方法，尤其是在儿童中。近年来，超微通道经皮肾镜取石术（UMP）已被用于治疗上尿路结石，以减少手术并发症并获得更可接受的治疗效果。不同医学中心报告的结果很有前景。
22例年龄小于8岁、上尿路结石大小在10至20毫米之间的儿童接受了UMP治疗。纳入标准为孤立性单侧肾结石、结石大小在10至20毫米之间、肾功能检查正常、无任何先天性畸形以及既往体外冲击波碎石术（ESWL）失败史。从患者病历中提取并记录的数据包括年龄、性别、患侧肾脏、结石大小、结石位置、手术时间、住院时间、结石成分、输血需求、邻近器官损伤、术后发热、术后败血症、麻醉需求、进一步补充治疗需求、结石清除率、术前和术后血红蛋白水平以及通道漏尿情况。
儿童的平均年龄（±标准差）为5.22（±1.57）岁。14例（63.6%）患者为男性。15例（68.2%）肾结石位于右肾，82%的患者结石位于肾盂。13例（59%）患者的结石由草酸钙组成。结石清除率为95.5%。所有病例均未报告通道漏尿、术后败血症、邻近器官损伤及输血需求。
超微通道经皮肾镜取石术是治疗儿童10至20毫米大小尿路结石的一种有效且安全的方法。
