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Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China.
Chin Med J (Engl) 2015; 128(12):1596-600CM

Abstract

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.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableDepartment of Urology, Beijing Tsinghua Changung Hospital, Medical Center, Tsinghua University, Beijing 102218, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26063360

Citation

Xiao, Bo, et al. "Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: a Single-center Initial Experience From China." Chinese Medical Journal, vol. 128, no. 12, 2015, pp. 1596-600.
Xiao B, Zhang X, Hu WG, et al. Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China. Chin Med J. 2015;128(12):1596-600.
Xiao, B., Zhang, X., Hu, W. G., Chen, S., Li, Y. H., Tang, Y. Z., ... Li, J. X. (2015). Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China. Chinese Medical Journal, 128(12), pp. 1596-600. doi:10.4103/0366-6999.158312.
Xiao B, et al. Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: a Single-center Initial Experience From China. Chin Med J. 2015 Jun 20;128(12):1596-600. PubMed PMID: 26063360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China. AU - Xiao,Bo, AU - Zhang,Xin, AU - Hu,Wei-Guo, AU - Chen,Song, AU - Li,Yu-Hong, AU - Tang,Yu-Zhe, AU - Liu,Yu-Bao, AU - Li,Jian-Xing, PY - 2015/6/12/entrez PY - 2015/6/13/pubmed PY - 2016/3/16/medline SP - 1596 EP - 600 JF - Chinese medical journal JO - Chin. Med. J. VL - 128 IS - 12 N2 - 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. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/26063360/Mini_percutaneous_Nephrolithotomy_Under_Total_Ultrasonography_in_Patients_Aged_Less_Than_3_Years:_A_Single_center_Initial_Experience_from_China_ L2 - http://Insights.ovid.com/pubmed?pmid=26063360 DB - PRIME DP - Unbound Medicine ER -