Treatment of renal calculi in pediatric patients with minimally invasive percutaneous nephrolithotomy / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the technique and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) for renal calculi in pediatric patients. Methods From April 2009 to December 2009, 12 pediatric patients (8 males and 4 females) with renal calculi were treated by MPCNL. The age ranged from 18 to 53 months (mean 32 months). All the 12 cases were diagnosed by KUB+IVU, ultrasonography and CT. The stone had average diameter of 1. 3 cm (ranged from 1. 0 to 1. 8 cm). Seven cases had simple renal pelvis stone and 5 cases had multiple renal calyx stone. UPJ stricture was not found in this series. General anaesthesia was applied. Renal transfixion pin was punctured to select renal calices by monitoring with ultrasonography. 12 - 16 F percutaneous renal access was successfully established in all cases and calculi were fragmented by pneumatic lithotripter. Results The average operative time of MPCNL was 74 min. Phase Ⅰ lithotripsy was underwent in all patients. The phase Ⅰ stone-free rate was 67%(8/12). One cases accepted second MPCNL. The calculus clearance rate reached 75%(9/12). Three cases had residual calculi ranged from 2 to 4 mm. One of whom had ESWL 2 weeks postoperatively. All cases were followed up for 1 - 7 months, all cases were in stone free status. Conclusion Regarding the advantages of less bleeding, high clearance rate, and shorter hospital stay, MPCNL is an effective and safe treatment option for renal calculi in pediatric patients.