Baltaci Kadir Emre, Hazir Berk, Altan Mesut, Bozaci Ali Cansu, Gasimov Kamranbay, Tekgul Serdar, Doğan Hasan Serkan
Hacettepe University Hospital, Ankara, Turkey.
Pediatr Surg Int. 2025 Sep 18;41(1):299. doi: 10.1007/s00383-025-06198-1.
The prevalence of stone disease in children is increasing, necessitating approaches using instruments of more suitable sizes for surgical treatment. We aim to convey our experience with Mini-PCNL.
We retrospectively analyzed a total of 72 renal units that underwent single-shot dilatation Mini-PCNL(≤ 17.5F) between August 2017 and November 2024. Univariate and multivariate analyses were used to assess the factors for surgical success (no postoperative residual) and complications.
Medians for our cohort were age at surgery was 5.5 years, operation time was 120 min, hospitalization time was 5 days, stone size was 2.04 cm. Overall SFR was 80.6%. We observed complications in 16 patients(%22.2). In univariate analysis; HU < 820, PCNL history, cystine stone, stone burden > 2 cm and stone length > 29 mm were found to be associated with lower success. In the multivariate analysis results, patients with a previous history of PCNL (56% vs 93.6%) (p = 0.005) and patients with a stone burden ≥ 2 cm (68.4% vs 94.1%) (p = 0.021) were found to be associated with less successful results. Univariate analysis revealed no single predictive factor for complication development.
Mini-PCNL is a surgical method that can be performed safely in the pediatric age group due to its high stone-free rate. However, it should be kept in mind that the success rates are lower in those with a history of PCNL due to anatomical challenges secondary to previous surgeries and with high stone burden. Patients with cystine stones deserve more effort to make them free of fragments.
儿童结石病的患病率正在上升，因此需要采用尺寸更合适的器械进行手术治疗。我们旨在分享我们使用迷你经皮肾镜取石术（Mini-PCNL）的经验。
我们回顾性分析了2017年8月至2024年11月期间接受单次扩张迷你经皮肾镜取石术（≤17.5F）的72个肾单位。采用单因素和多因素分析来评估手术成功（无术后残留）和并发症的因素。
我们队列的中位数为手术年龄5.5岁，手术时间120分钟，住院时间5天，结石大小2.04厘米。总体无石率为80.6%。我们观察到16例患者出现并发症（22.2%）。在单因素分析中；发现HU＜820、有经皮肾镜取石术病史、胱氨酸结石、结石负荷＞2厘米和结石长度＞29毫米与较低的成功率相关。在多因素分析结果中，发现有经皮肾镜取石术病史的患者（56%对93.6%）（p = 0.005）和结石负荷≥2厘米的患者（68.4%对94.1%）（p = 0.021）与较低的成功结果相关。单因素分析未发现并发症发生的单一预测因素。
由于其较高的无石率，迷你经皮肾镜取石术是一种可在儿童年龄组安全进行的手术方法。然而，应牢记，由于既往手术导致的解剖学挑战以及结石负荷高，有经皮肾镜取石术病史的患者成功率较低。患有胱氨酸结石的患者需要付出更多努力使其无碎片残留。
