College of medicine, University of Anbar, Ramadi, Al Anbar, Iraq.
University of Baghdad, College of medicine, Baghdad, Iraq.
Urolithiasis. 2024 Oct 14;52(1):142. doi: 10.1007/s00240-024-01643-7.
To assess the use of miniaturized percutaneous nephrolithotomy (mini-PCNL) for renal stones in children, as well as its safety and efficacy. Seventy-seven patients with more than 15 mm renal stones whose age was less than 15 years were enrolled in this prospective case-controlled study at Al-Ramadi Teaching Hospital, Ar Razi Private Hospital, and Ghazi Al-Hariri Hospital for Surgical Specialties, Anbar and Baghdad, Iraq. The study was conducted from January 2020 to January 2024. The group mentioned above served as group A, and it was compared to the control group (group B), which consisted of 70 adult patients aged 18-60 years. Patients in both groups underwent mini-PCNL. Gender, stone size and location, time of operation, stone-free rate, hemoglobin drop, need for blood transfusion, postoperative fever, associated visceral injury, and need for further interventions such as extracorporeal shock wave lithotripsy or flexible ureteroscopy (ESWL or FURS) were compared in both groups. The age of patients in group A ranged from 8 months to 15 years with a mean (4.30 ± 3.16), while in group B ranged from 18 to 60 years with a mean (36.3 ± 12.0), p-value 0.001. There were no statistically significant differences regarding gender distribution, stone size, and location, p-value > 0.05. The stone-free rate was 87.01% for group A and 88.57% for group B, with no statistical difference, p-value 0.773. Hemoglobin drop was 1.096 ± 0.412 for group A and 1.195 ± 0.110 for group B, p-value 0.046. Blood transfusion was needed in one case in each group with no statistical difference, p-value 0.946. The need for ESWL was 3 cases in group A, and 2 cases in group B, with no statistical difference between the two groups, p-value 0.729. The need for FURS was 4 cases in group A and 3 cases in group B, p-value 0.796. Operative time was 30 to 125 min in group A and 34 to 129 min in group B, p-value 0.941. Postoperative fever was seen in 23 cases in group A and 21 cases in group B, p-value 0.986. Minor liver injury was seen was seen in one case in each group. The use of mini-PCNL for treating renal stones in children is safe and effective as it is associated with a relatively low rate of significant complications and achieves a high stone-free rate.
评估小儿微创经皮肾镜取石术（mini-PCNL）治疗肾结石的安全性和疗效。本前瞻性病例对照研究纳入了伊拉克安巴尔省和巴格达省的拉马迪教学医院、阿尔拉齐私立医院和加济·哈里里外科专科医院 77 例年龄小于 15 岁、肾结石大于 15mm 的患者。研究时间为 2020 年 1 月至 2024 年 1 月。上述患者为 A 组，与对照组（B 组）进行比较，B 组由 70 例年龄 18-60 岁的成年患者组成。两组患者均行 mini-PCNL 治疗。比较两组患者的性别、结石大小和位置、手术时间、结石清除率、血红蛋白下降、输血需求、术后发热、相关内脏损伤以及是否需要进一步干预，如体外冲击波碎石术（ESWL）或输尿管软镜碎石术（FURS）。A 组患者年龄 8 个月至 15 岁，平均年龄（4.30±3.16）岁，B 组患者年龄 18-60 岁，平均年龄（36.3±12.0）岁，p 值 0.001。两组患者性别分布、结石大小和位置比较差异无统计学意义，p 值>0.05。A 组结石清除率为 87.01%，B 组为 88.57%，差异无统计学意义，p 值 0.773。A 组血红蛋白下降 1.096±0.412，B 组血红蛋白下降 1.195±0.110，p 值 0.046。两组各有 1 例需要输血，差异无统计学意义，p 值 0.946。A 组需要 ESWL 治疗 3 例，B 组需要 ESWL 治疗 2 例，两组差异无统计学意义，p 值 0.729。A 组需要 FURS 治疗 4 例，B 组需要 FURS 治疗 3 例，差异无统计学意义，p 值 0.796。A 组手术时间为 30-125min，B 组手术时间为 34-129min，差异无统计学意义，p 值 0.941。A 组术后发热 23 例，B 组术后发热 21 例，差异无统计学意义，p 值 0.986。两组各有 1 例出现轻微肝损伤。mini-PCNL 治疗儿童肾结石安全有效，并发症发生率相对较低，结石清除率高。
