Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years
Background:. Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2015-06-01
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| Series: | Chinese Medical Journal |
| Online Access: | http://journals.lww.com/10.4103/0366-6999.158312 |
| _version_ | 1797646863226109952 |
|---|---|
| author | Bo Xiao Xin Zhang Wei-Guo Hu Song Chen Yu-Hong Li Yu-Zhe Tang Yu-Bao Liu Jian-Xing Li |
| author_facet | Bo Xiao Xin Zhang Wei-Guo Hu Song Chen Yu-Hong Li Yu-Zhe Tang Yu-Bao Liu Jian-Xing Li |
| author_sort | Bo Xiao |
| collection | DOAJ |
| description | Background:. Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years.
Methods:. We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6-36 months), and the mean maximum stone diameter was 19.2 mm (range 10-35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12-16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.
Results:. Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8-5.0 min), the mean operative time was 36.5 min (range 20-88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2-15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3-13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed.
Conclusions:. This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure. |
| first_indexed | 2024-03-11T15:08:52Z |
| format | Article |
| id | doaj.art-7fa23263e23c48429ca62aa68f0d8e1e |
| institution | Directory Open Access Journal |
| issn | 0366-6999 2542-5641 |
| language | English |
| last_indexed | 2024-03-11T15:08:52Z |
| publishDate | 2015-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-7fa23263e23c48429ca62aa68f0d8e1e2023-10-30T03:37:28ZengWolters KluwerChinese Medical Journal0366-69992542-56412015-06-01128121596160010.4103/0366-6999.158312cm9-128-1596Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 YearsBo Xiao0Xin Zhang1Wei-Guo Hu2Song Chen3Yu-Hong Li4Yu-Zhe Tang5Yu-Bao Liu6Jian-Xing Li71 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China1 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China1 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China1 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China2 Department of Operating Room, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China1 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China1 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China1 Department of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, ChinaBackground:. Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years. Methods:. We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6-36 months), and the mean maximum stone diameter was 19.2 mm (range 10-35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12-16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope. Results:. Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8-5.0 min), the mean operative time was 36.5 min (range 20-88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2-15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3-13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed. Conclusions:. This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.http://journals.lww.com/10.4103/0366-6999.158312 |
| spellingShingle | Bo Xiao Xin Zhang Wei-Guo Hu Song Chen Yu-Hong Li Yu-Zhe Tang Yu-Bao Liu Jian-Xing Li Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years Chinese Medical Journal |
| title | Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years |
| title_full | Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years |
| title_fullStr | Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years |
| title_full_unstemmed | Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years |
| title_short | Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years |
| title_sort | mini percutaneous nephrolithotomy under total ultrasonography in patients aged less than 3 years |
| url | http://journals.lww.com/10.4103/0366-6999.158312 |
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