Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-To-Be-University), JNMC Campus, Belagavi, Karnataka, 590010, India.
Department of Urology, Urinary Biomarkers Research Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, 590010, India.
Pediatr Surg Int. 2021 Aug;37(8):1109-1115. doi: 10.1007/s00383-021-04901-6. Epub 2021 Apr 15.
The high success rates of percutaneous nephrolithotomy (PCNL) in the clearance of large renal calculi has made it a primary mode of surgical management in adults. Similarly, in children too PCNL has been gaining ground and the indications for the same are on the rise. We retrospectively evaluated the safety and efficacy of this technique, in children below 18 years of age.
We retrospectively reviewed the inpatient, outpatient records, imaging films of all children with renal stones undergoing PCNL at our hospital.
During the study period, 123 children underwent 129 PCNL at our centre for renal calculi. The mean age was 11.06 years and 87 (70.73%) of the children were males. The size of the stones varied from 15 to 37 mms in the longest diameter. A complete staghorn was noted in six (4.65%) and a partial staghorn in nine (6.97%) children. Supine PCNL was performed in 21 (16.2%) children and remaining 102 (83.7%) children underwent PCNL in prone position. The mean drop in haemoglobin was 1.24 gm%. Stone clearance was achieved in 122 (94.5%) children. Post-operatively four (3.1%) children needed blood transfusions due to excessive bleeding.
Refinements in percutaneous access techniques, miniaturization of instruments, and technologic advances in energy sources for lithotripsy have led to improvement of outcomes and have lowered the morbidity rates in children following PCNL. It is a safe and effective means of clearing large volumes of renal calculi with minimal morbidity.
经皮肾镜碎石术（PCNL）在清除大肾结石方面的高成功率使其成为成人外科治疗的主要方式。同样，PCNL 在儿童中也越来越受欢迎，适应证也在不断增加。我们回顾性评估了该技术在 18 岁以下儿童中的安全性和有效性。
我们回顾性地审查了我院所有接受 PCNL 治疗肾结石的住院和门诊病历、影像学资料。
在研究期间，我院有 123 名儿童接受了 129 次 PCNL 治疗肾结石。平均年龄为 11.06 岁，87 名（70.73%）为男性。结石最大直径为 15-37mm。6 名（4.65%）为完全鹿角形结石，9 名（6.97%）为部分鹿角形结石。21 名（16.2%）儿童行仰卧位 PCNL，其余 102 名（83.7%）儿童行俯卧位 PCNL。血红蛋白平均下降 1.24g%。122 名（94.5%）儿童结石清除。术后 4 名（3.1%）儿童因出血过多需要输血。
经皮穿刺技术的改进、器械的小型化以及碎石能量源的技术进步，提高了儿童 PCNL 术后的结果，降低了发病率。它是一种安全有效的清除大量肾结石的方法，具有最小的发病率。
