Eslahi Ali, Hosseini Mohammad Mehdi, Ahmed Faisal, Tanaomi Delara, Hosseini Seyyed Hossein, Askarpour Mohammad Reza, Nikbakht Hossein-Ali, Al-Naggar Khalil
Department of Urology, School of Medicine, Shiraz University of Medical Sciences; Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Nephrology-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Afr J Paediatr Surg. 2022 Apr-Jun;19(2):68-72. doi: 10.4103/ajps.AJPS_13_21.
The objective of the study was to assess the outcome and feasibility of ultrasonography (US)-guided minimally invasive percutaneous nephrolithotomy (mini-PCNL) in children.
Twenty-five children with upper urinary tract stones who had undergone US-guided mini-PCNL from June 2017 to June 2020 were enrolled in this study. Patients' demographic information and post-treatment results were retrospectively gathered and analysed. Pyelocaliceal system was punctured in prone position using US guidance, and the tract was dilated using single-shot dilation technique. All steps of renal access were done using only US. Mini-PCNL in all cases was done by using 15 Fr rigid nephroscope. Stones were fragmented with a pneumatic lithotripter and evacuated.
The patients' mean age was 6.30 ± 3.25 years (range: 1.5-15). The mean stone size was 16.04 ± 3.93 mm (range: 10-30). The mean access time to the stone was 1.50 ± 0.62 min (range: 1-4). The mean operation time was 94.66 ± 3.05 min (range: 90-100 min). The final stone-free rate was 96%. Post-operation fever occurred in 4 (16%) patients who were treated successfully with an antibiotic. No major complications occurred.
We recommend US-guided mini-PCNL as a harmless alternative treatment option, in children with renal calculi due to its excellent outcomes and little complications.
本研究的目的是评估超声（US）引导下微创经皮肾镜取石术（mini-PCNL）在儿童中的治疗效果及可行性。
选取2017年6月至2020年6月期间接受US引导下mini-PCNL治疗的25例上尿路结石患儿纳入本研究。回顾性收集并分析患者的人口统计学信息及治疗后结果。在俯卧位使用US引导穿刺肾盂肾盏系统，并采用单次扩张技术扩张通道。所有肾穿刺步骤均仅使用US完成。所有病例均使用15F硬性肾镜进行mini-PCNL。用气压弹道碎石机将结石击碎并取出。
患者的平均年龄为6.30±3.25岁（范围：1.5 - 15岁）。平均结石大小为16.04±3.93mm（范围：10 - 30mm）。平均结石穿刺进入时间为1.50±0.62分钟（范围：1 - 4分钟）。平均手术时间为94.66±3.05分钟（范围：90 - 100分钟）。最终结石清除率为96%。4例（16%）患者术后发热，经抗生素治疗成功。未发生重大并发症。
由于其良好的治疗效果和较少的并发症，我们推荐US引导下的mini-PCNL作为儿童肾结石的一种安全有效的替代治疗选择。
