1Department of Urology, Minimally Invasive Surgery Center, First Affiliated Hospital of Guangzhou Medical College,Guangzhou, 510230,China; 2Department of Urology, Xinhua Hospital of Shanghai Jiaotong Medical University
Abstract：Objective:The efficiency was compared between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants < 3 years.Methods:Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).Of the two groups,the mean age was(22.62±8.69) months and (23.50±6.64) month, while the stone size was (21.44±3.50)mm and (21.73±1.70)mm.Results:In MPCNL group, one had bilateral stones. Mean operating time was (76.20±23.42) min with mean hospital stay of (14.13±5.80) d. The stone-free rates were 84% (21/25) after first session and 96% (24/25) after second-look procedure. Postoperative fever happened in 4 (16%) cases. Hemoglobin drop was (8.54±4.40) g/L and no one needed blood transfusion. In ESWL group, the stone-free rate were 31.82%(7/22)after first session and 86.3%(19/22) after second session for 11 infants(50%). Mean hospital stay was (6.64±2.28)d and 10 cases (45.5%) happened complications. Hemoglobin drop was (10.64±12.67) g/L. For complications rate and re-treatment rate, MPCNL was lower than ESWL (P<0.05), and the stone-free rate was higher (P<0.05), but the hospital stay and operate time was longer (P<0.05). Renal function evaluation after management (in terms of serum creatinine (SCr) and glomerular filtration rate (GFR) revealed no significant change in both groups.Conclusions:Compared to ESWL, MPCNL,with a higher success rate, a lower complication rate and re-treatment rate, was an effective option for the management of relatively larger stones in children (even in infants) when performed by experienced endourologists.
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