Department of Urology, Baskent University, Alanya A&R Center, Antalya, Türkiye.
Department of Urology, Adana City Training and Research Hospital, Health Sciences University, Adana, Türkiye.
Langenbecks Arch Surg. 2024 Jul 8;409(1):207. doi: 10.1007/s00423-024-03402-z.
This study aimed to compare the results of retrograde intrarenal surgery (RIRS) and mini-percutaneous nephrolithotomy (mini-PCNL) for the treatment of 1-2 cm kidney stones in pediatric patients.
The records of patients under the age of 18 years who were diagnosed with unilateral 1-2 cm kidney stones for the first time and underwent endoscopic surgery between February 2008 and April 2022 were retrospectively examined. The patients were divided into two groups: mini-PCNL and RIRS surgery. Parameters such as age, gender, number of stones, side, size and localization were examined. The main endpoint of the study was to compare stone-free rates (SFR) one month after both surgeries. Surgery and fluoroscopy times, postoperative hospital stay, hemoglobin decrease and complication rates were compared between the groups. SFR was evaluated one month after surgery by direct urinary system radiography and USG or CT.
A total of 58 patients were included in the study. There were 35 patients in the mini-PCNL group and 23 patients in the RIRS group. Table 1 shows the demographic and clinical characteristics of both groups. There was no significant difference between the groups in terms of age, gender, stone size, location, side and density. Calcium oxalate stones were observed at a higher rate in both groups. Mean fluoroscopy time was higher in the mini-PCNL group (p = 0.001). The mean surgery time was lower in the mini-PCNL group (p = 0.024). The mean hemoglobin decrease was greater in the percutaneous group (p = 0.039). There were no differences between the groups in terms of postoperative hospital stay, complication rates, and SFR one month after surgery.
Although mini-PCNL seems to be more advantageous in terms of operation time compared to RIRS, it is disadvantageous in terms of average fluoroscopy time, radiation received and average hemoglobin decrease.
本研究旨在比较逆行肾内手术（RIRS）和小经皮肾镜取石术（mini-PCNL）治疗儿童 1-2cm 肾结石的结果。
回顾性分析 2008 年 2 月至 2022 年 4 月期间因单侧 1-2cm 肾结石首次诊断为肾结石且接受内镜手术的 18 岁以下患者的病历。将患者分为两组：mini-PCNL 组和 RIRS 手术组。检查年龄、性别、结石数量、侧别、大小和定位等参数。研究的主要终点是比较两种手术一个月后的无结石率（SFR）。比较两组间手术时间和透视时间、术后住院时间、血红蛋白下降和并发症发生率。术后一个月通过直接尿路造影和 USG 或 CT 评估 SFR。
共纳入 58 例患者，其中 mini-PCNL 组 35 例，RIRS 组 23 例。表 1 显示了两组的人口统计学和临床特征。两组在年龄、性别、结石大小、位置、侧别和密度方面无显著差异。两组均以草酸钙结石为主。mini-PCNL 组透视时间平均较高（p=0.001）。mini-PCNL 组手术时间平均较低（p=0.024）。经皮组平均血红蛋白下降较多（p=0.039）。两组术后住院时间、并发症发生率和术后一个月 SFR 无差异。
虽然与 RIRS 相比，mini-PCNL 在手术时间方面似乎更有优势，但在平均透视时间、辐射量和平均血红蛋白下降方面处于劣势。
