Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China.
Peking University Applied Lithotripsy Institute, Beijing, China.
J Invest Surg. 2021 Oct;34(10):1078-1082. doi: 10.1080/08941939.2020.1764154. Epub 2020 May 13.
To evaluate the outcome of ultrasound (US)-guided minimally invasive percutaneous nephrolithotomy (MPCNL) in the management of upper ureteral and renal stones in pediatric patients.
We collected data of 112 pediatric patients who were admitted to the xxxx between March 2006 and December 2016 and treated by US-guided MPCNL. Our cohort included upper ureter stones ( = 11), single kidney stones ( = 46), multiple kidney stones ( = 56), and staghorn kidney stones ( = 12).
Patients were between 0.5 and 13 years old with stone sizes from 10 to 50 mm. Operation duration ranged from 15 to 195 minutes. On average, the nephrostomy tube could be removed after 3.9 days and patients were discharged after 6.5 days. We found that hemoglobin concentration decreased in 34 patients after surgery by 1 to 37.8 g/L. Using US-guided MPCNL, the initial stone-free rate (SFR) was 86.4% and resulted in a final SFR of 95.2%. However, postoperative complications occurred in 18 patients including > 38.5 °C fever in 17 cases and reactive pleural effusion in one case. Blood transfusion was not required in all cases and no sepsis, kidney loss, ureteral stricture, and adjacent organ injury were observed. Follow-up after an average of 8.5 months showed normal renal function without hydronephrosis. However, recurrence of stones > 4 mm was found in 11 patients.
US-guided MPCNL showed an excellent SFR and low complication rate in the management of pediatric patients with upper ureteral and renal stones.
评估超声引导微创经皮肾镜取石术（MPCNL）治疗小儿上尿路和肾结石的疗效。
我们收集了 2006 年 3 月至 2016 年 12 月期间在 xxxx 接受超声引导 MPCNL 治疗的 112 例小儿患者的数据。我们的队列包括上尿路结石（11 例）、单发肾结石（46 例）、多发肾结石（56 例）和鹿角肾结石（12 例）。
患者年龄 0.5-13 岁，结石大小 10-50mm。手术时间 15-195 分钟。平均术后 3.9 天拔除肾造瘘管，术后 6.5 天出院。我们发现 34 例患者术后血红蛋白浓度下降 1-37.8g/L。使用超声引导 MPCNL，初始结石清除率（SFR）为 86.4%，最终 SFR 为 95.2%。但术后有 18 例患者发生并发症，包括 17 例体温>38.5℃和 1 例反应性胸腔积液。所有患者均未输血，未发生感染性休克、肾丢失、输尿管狭窄和邻近器官损伤。平均 8.5 个月的随访显示肾功能正常，无肾积水。但有 11 例患者发现>4mm 的结石复发。
超声引导 MPCNL 治疗小儿上尿路和肾结石具有较高的结石清除率和较低的并发症发生率。
