Department of Urology, Ilam University of Medical Sciences, Ilam, Iran.
Development Unit, Imam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran.
Urolithiasis. 2024 Apr 18;52(1):68. doi: 10.1007/s00240-024-01540-z.
Percutaneous nephrolithotomy (PCNL) is an endourological method applied as the standard or tubeless method for kidney stone treatment. In a retrospective cohort study, 88 surgery units involving 75 children up to 18 years old with kidney stones who underwent the surgery for 8 years in Shahid Beheshti and Boo-ali hospitals in Hamadan with one of the two methods of standard or tubeless PCNL were evaluated and compared considering the success rate of operation, hemoglobin, hematocrit drop, need for medications, need for blood transfusion, duration of surgery, and the length of hospital stay. Among the 88 units studied, 47 cases were operated with the standard PCNL and 41 cases by tubeless method. In children operated by standard and tubeless PCNL, the complete success rate of operation was 87.2% and 100% (P = 0.006), the need for blood transfusion was 2.1% and 0% (P = 1.00), the need for opioids was 27.7% and 14.6% (P = 0.134), the decrease in hemoglobin was - 1.82 ± 0.94 and -1.30 ± 0.98 mg/dl (P = 0.024), the decrease in hematocrit was - 5.40 ± 2.66 and -3.52 ± 3.11 mg/dL (P = 0.003), the mean surgery duration was 109.30 ± 53.27 and 101.46 ± 31.92 min (P = 0.414), the duration of postoperative hospitalization was 3.38 ± 1.76 and 2.46 ± 1.27 days (P = 0.007), and the frequency of fever was 23.4% and 7.3% (P = 0.04), respectively. The success rate of kidney stone surgery in children with the tubeless PCNL is higher than the standard method, and its complications are lower.
经皮肾镜碎石术 (PCNL) 是一种内镜方法，适用于肾结石治疗的标准或无管方法。在一项回顾性队列研究中，评估了 88 个手术单位，这些单位涉及 75 名 18 岁以下的肾结石儿童，他们在哈马丹的沙希德·贝赫什提和布阿里医院接受了 8 年的手术，其中 2 种方法之一为标准 PCNL 或无管 PCNL，比较了手术成功率、血红蛋白、血细胞比容下降、药物需求、输血需求、手术持续时间和住院时间。在所研究的 88 个单位中，47 例采用标准 PCNL 进行手术，41 例采用无管方法进行手术。在接受标准和无管 PCNL 手术的儿童中，手术完全成功率分别为 87.2%和 100%（P=0.006），输血需求分别为 2.1%和 0%（P=1.00），需要阿片类药物的比例分别为 27.7%和 14.6%（P=0.134），血红蛋白下降分别为 -1.82±0.94 和 -1.30±0.98 mg/dl（P=0.024），血细胞比容下降分别为 -5.40±2.66 和 -3.52±3.11 mg/dL（P=0.003），手术时间平均分别为 109.30±53.27 和 101.46±31.92 min（P=0.414），术后住院时间分别为 3.38±1.76 和 2.46±1.27 天（P=0.007），发热频率分别为 23.4%和 7.3%（P=0.04）。儿童无管 PCNL 肾结石手术成功率高于标准方法，并发症发生率较低。
