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超声引导下微创经皮肾镜取石术治疗儿童上尿路结石:单中心评估

Ultrasound-guided mini-percutaneous nephrolithotomy in the treatment of upper urinary tract stones in children: A single-center evaluation.

作者信息

Simayi Abulizi, Tayier Talaiti, Aimaier Aihemaiti, Lei Peng, Zhang Xiaoan, Alimu Yalikun

机构信息

Department of Urology, People's Hospital of Xinjiang Uyghur Autonomous Region, Tianchi Road, Tianshan District, Urumqi, 830001, China.

Department of Urology, People's Hospital of Xinjiang Uyghur Autonomous Region, Tianchi Road, Tianshan District, Urumqi, 830001, China.

出版信息

Asian J Surg. 2023 Jan;46(1):1-5. doi: 10.1016/j.asjsur.2022.01.069. Epub 2022 Feb 23.

Abstract

To evaluate the safety and efficacy of ultrasound-guided mini-percutaneous nephrolithotomy (mini-perc) for the treatment of upper urinary tract stones in children. We reviewed the records of 70 children with upper urinary tract stones who were treated with a mini-perc technique between July 2015 and April 2020. All puncture site selections and tract dilations were determined by Doppler ultrasonography. Patient age, height, weight, stone size, operation time, stone-free rate (SFR), postoperative complications, tubeless rate, and length of hospital stay (LOS) were recorded. Stone components were analysed using infrared spectroscopy. A total of 47 boys and 23 girls were included. Median weight and height of the patients were 18.5 kg and 110 cm, respectively. Median stone diameter was 2.0 cm. Median time to establish access was 4.0 min and median operation time was 25 min. Patients had median preoperative and postoperative haemoglobin levels of 121 and 113.5 g/L, median haemoglobin levels dropped to 8.0 g/L the day after surgery. No patient needed a blood transfusion. Eight children (11.4%) developed significant complications, including four cases with Clavien Grade I, one with Clavien Grade II, and three with Clavien Grade Ⅲ complications. One-day and 1-month follow-ups revealed a complete SFR of 95.7% (67/70) and 97.1% (68/70), respectively. Fifty-six patients (80.0%) did not require catheters of any type (total tubeless). Median LOS was 2.0 days. Ultrasound-guided mini-perc is safe and effective. The mini-perc technique is a feasible alternative for paediatric stone disease that does not result in major complications.

摘要

评估超声引导下微创经皮肾镜取石术(mini-perc)治疗儿童上尿路结石的安全性和有效性。我们回顾了2015年7月至2020年4月间采用mini-perc技术治疗的70例儿童上尿路结石患者的记录。所有穿刺点选择和通道扩张均由多普勒超声确定。记录患者的年龄、身高、体重、结石大小、手术时间、结石清除率(SFR)、术后并发症、无管率和住院时间(LOS)。使用红外光谱分析结石成分。共纳入47例男孩和23例女孩。患者的中位体重和身高分别为18.5kg和110cm。结石中位直径为2.0cm。建立通道的中位时间为4.0分钟,中位手术时间为25分钟。患者术前和术后血红蛋白水平的中位数分别为121g/L和113.5g/L,术后第一天血红蛋白水平中位数降至8.0g/L。无患者需要输血。8名儿童(11.4%)出现严重并发症,包括4例Clavien I级、1例Clavien II级和3例Clavien III级并发症。术后1天和1个月的随访显示结石完全清除率分别为95.7%(67/70)和97.1%(68/70)。56例患者(80.0%)不需要任何类型的导管(完全无管)。中位住院时间为2.0天。超声引导下mini-perc是安全有效的。mini-perc技术是小儿结石病的一种可行替代方法,不会导致严重并发症。

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