The mini-percutaneous nephrolithotomy for the treatment of upper urinary tract calculi in children (Report of 149 cases)
Long Dazhi1, Wu Yuting1, Zou Xiaofeng1, Yuan Yuanhu1, Xiao Rihai1, Zhang Guoxi1, Wu Gengqing1, Wang Xiaoning1, Liu Folin1, Xue Yijun1, Liu Quanliang1, Xu Hui1, Yang Jun1, Liao Yunfeng1, Xu Ruiquan1
1Department of Urology, Affiliated Hospital of Gannan Medical University;Jiangxi Provincial Center for Modern Treatment of Urolithiasis, Ganzhou, 341000, China
Abstract：Objective:To evaluate the clinical value of mini-percutaneous nephrolithotomy (MPCNL) for the treatment of upper urinary tract calculi in children. Methods:A total of 149 cases with upper urinary tract calculi were treated by MPCNL. The mean age was 8.7 yearsold(ranging from 1 to 16). The calculi were found on left side in 80 cases, right side in 58, and both side in 11. The smallest size of the calculus was 0.6 cm×0.6 cm, the largest was 2.6 cm ×1.8 cm (mean 1.3 cm×0.9 cm). The children with lower ureteral stones and with bladder stones underwent ureteroscopic lithotomy (URL) and minimally invasive percutaneous cystolithotripsy (PCCL). Some stones which were not detected by rigid ureteroscopy were treated by flexible ureteroscopy. Results:All the procedures were successful. The mean operative time for unilateral MPCNL was 50 (range 20 to 65) mins. Stones were cleared using one MPCNL session in 131 (87.9%),two sessions in 9 (6.04%).One hundred and fourty two of 149 children (95.3%) were cleared of their stones in all.Simultaneous bilateral MPCNLs were performed in 11 children. Thirteen children underwent tubeless-MPCNL. One child underwent totally tubeless-MPCNL. The mean length of hospital stay was 7.2 (range 3 to 15) days. Conclusions:MPCNL appears to be a safe, minimally invasive, and quick recovery procedure for upper urinary tract calculi in children. In some selective patients tubeless-MPCNL could be performed. Flexible ureteroscopy could improve the stone clearance rate of MPCNL.
