Initial report of SMP in the treatment of pediatric nephrolithiasis
Liu Yongda1 Aierken Tuerxun2 Cai Chao1 Liu Yang1 Abudukahaer Batuer2 Zhou Yizhou1 Luo Jiawei1 Wu Wenqi1 Chen Wenzhong1 Zhong Wen1 Zeng Guohua1
1Department of Urology, Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou 510230, China; 2 Department of Urology, the First People's Hospital of Kashgar Area
Abstract：Objective: To evaluate the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP) in the treatment of pediatric renal stones. Methods: Data of 51 pediatric patients with renal stones who were managed by SMP in the First People's Hospital of Kashi from September 2014 to September 2015 were retrospectively reviewed, including 32 boys and 19 girls. The mean age of patients was (2.9±2.4) years (range: 5 months to 12 years). The mean stone burden was (1.9±0.7) cm (range: 0.8 to 4.8 cm). Results: Of 51 cases, 49 cases were managed by SMP successfully in one session, however, 2 cases were given two-stage SMP due to pyonephrosis. The mean operative time was (49.8±15.5) min. The mean hemoglobin drop was found to be (10.4±4.7) g/L and no transfusion was needed. There were 44 cases (86.3%) without nephrostomy tube or ureteric stent (totally tubeless), 2 cases (3.9%) only with ureteric catheter, 2 cases (3.9%) with nephrostomy tube and ureteric catheter, and 3 cases (5.9%) with nephrostomy tube and double J stent. The stone-free rate (SFR) at 24 h and 3 months was 86.3% and 90.2%, respectively. Clavien Ⅰ/Ⅱ complication rate was 15.7% (8/51), 基金项目:广东省科技计划项目(2016A020212023);广州市科技计划项目(201507020026) including 3 cases of postoperative fever, 1 case of hematuria, 2 cases of minimal pelvis perforation and 2 cases of urinary extravasation. The postoperative hospital stay was (2.7±1.0) days. Conclusions: SMP is safe and effective for the management of <2.5 cm renal stones in children. SMP could be an ideal alternative modality for pediatric renal stones that not amenable to extracorporeal shock wave lithotripsy or flexible ureteroscopic lithotripsy.
[1]Dwyer ME, Krambeck AE, Bergstralh EJ, et al. Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol, 2012,188(1):247-252. [2]Zeng G, Wan S, Zhao Z, et al. Super-mini percutaneous nephrolithotomy (SMP): a new concept in technique and instrumentation. BJU Int, 2016,117(4):655-661
