Özçift Burak, Tiryaki Hüseyin Tuğrul
Health Sciences University, Izmir Dr. Behcet Uz Child Diseases and Surgery Training and Researching Hospital. Pediatric Urology Unit. Izmir. Turkey.
Health Sciences University. Ankara Child Health and Diseases Hematology Oncology Training and Researching Hospital. Pediatric Urology Clinic. Ankara. Turkey.
Arch Esp Urol. 2020 Sep;73(7):643-650.
To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrarenal surgery (RIRS) in children with 10-20 mm renal stones. MATERIALS AND METHODS: Between 2015 and 2019, 63 pediatric patients aged under 16 years who under went mini-PNL and RIRS for the treatment of kidney stones sized 10-20 mm were analyzed retrospectively. The mini-PNL group (n=30) was defined as group 1 and the RIRS group (n=33) was defined as group 2. Peri-operative data including stone-free rate, operative time, fluoroscopy time, hospitalization time, number of anesthesia sessions, complication rates, and cost-effectiveness were analyzed.
The mean age was 8.09±5.49 years in group 1 and 5.75±4.56 years in group 2. The stone free rate was not different at the first (80.0% vs. 57.6%) and third month (93.3% vs. 90.9%) follow-up in group 1 and group 2. The mean hospitalization, operative, and fluoroscopy times were statistically significantly longer in group 1. The mean number of anesthesia sessions for patients was 1.20±0.40 in group 1 and 2.15±0.44 in group 2 (p=0.00). Minor complication rates were not different and no major complications were observed in either group. The cost per patient was calculated as 365.97 Euros in group 1 and 698.64 Euros in group 2 (p=0.001). CONCLUSIONS: This study suggested that RIRS was an effective alternative treatment method for 10-20 mm kidney stones in children, with comparable stone-free and complication rates. RIRS has a shorter operative time, fluoroscopy time, hospital stay than mini-PNL, with a similar stone-free rate for 10-20 mm kidney stones in children. However, mini-PNL is cheaper and allowed a lower need for anesthesia sessions.
比较微创经皮肾镜取石术（mini-PNL）与逆行肾内手术（RIRS）治疗10 - 20毫米肾结石患儿的效果。材料与方法：回顾性分析2015年至2019年间63例16岁以下因10 - 20毫米肾结石接受mini-PNL和RIRS治疗的儿科患者。mini-PNL组（n = 30）定义为第1组，RIRS组（n = 33）定义为第2组。分析围手术期数据，包括结石清除率、手术时间、透视时间、住院时间、麻醉次数、并发症发生率和成本效益。
第1组平均年龄为8.09±5.49岁，第2组为5.75±4.56岁。第1组和第2组在首次（80.0%对57.6%）和第三个月随访（93.3%对90.9%）时结石清除率无差异。第1组的平均住院时间、手术时间和透视时间在统计学上显著更长。第1组患者的平均麻醉次数为1.20±0.40次，第2组为2.15±0.44次（p = 0.00）。两组的轻微并发症发生率无差异，且两组均未观察到严重并发症。第1组每位患者的费用计算为365.97欧元，第2组为698.64欧元（p = 0.001）。结论：本研究表明，RIRS是治疗儿童10 - 20毫米肾结石的一种有效替代治疗方法，结石清除率和并发症发生率相当。与mini-PNL相比，RIRS的手术时间、透视时间和住院时间更短，对于儿童10 - 20毫米肾结石的结石清除率相似。然而，mini-PNL更便宜，且麻醉需求更低。
