1.Clinical study of mini-percutaneous nephrolithotomy for upper urinary stones in children of Uygur nationality
Jing XIAO ; ·ABDUKADIR ANWAR ; MAMAT · HASANJAN ; GHALIP · ABDULAZIZ ; MAMAT · AKBARJAN ; Quanbin GUO ; ZAKIR · ABLIKIM ; Xuwen SHI
International Journal of Surgery 2018;45(9):596-599,封3
Objective To explore the safety and effectiveness of Mini-percutaneous nephrolithotomy (MPCNL)in the treatment of upper urinary stones in uygur children.Methods Retrospectively analyzed the date 158 cases of upper urinary stones in children treated by MPCNL in xinjiang hotan people's hospital from March to December 2016,117 cases of males and 41 cases of females,aged from 5 months to 14 years (average:2.59 years),including 112 cases of 5 months to 3 years old and 46 cases of 3 to 14 years old.There were 69 cases on the left,67 cases on the right and 22 cases on both sides.The average stone size was 2.3 cm × 1.8 cm.According to the size of the calculi,the percutaneous renal channel was selected between 12-18 F,the energy was selected for holmium laser lithotripsy,no perfusion pump was used and the hydrostatic pressure was controlled at 50 to 70 cm water column.Double J tube and renal fistula were placed postoperatively in 139 children;15 cases were not treated with renal fistula and 4 cases were completely free of tubulization.To observe the number and proportion of children with fever before and after operation.For multiple stones,use the accumulative maximum diameter calculation.To observe the changes of blood routine indexes before and after surgery,as well as operation time,puncture site,channel size and number,length of hospital stay,stone removal rate,stone composition and other postoperative complications.Counting data was expressed as a rate (%),and comparison between groups was performed by chi-square test.Results A total of 180 cases were successfully operated on kidney MPCNL.No complications above ClavienⅡ occurred.Two cases were treated with 1 unit of postoperative erythrocyte transfusion.The time of unilateral operation was 15 to 85 minutes with an average of 35 minutes.The first-stage stone clearance rate was 88.6% (140/158) and the total stone clearance rate was 92.4% (146/158).Postoperative hospitalization ranged from 3 to 8 days with an average of 6.2 days.Condusion MPCNL was used to treat upper urinary stones with high efficiency and safety and little damage for children with large stones or combined with water accumulation.Some appropriate children can be free of renal fistula or complete absence of tubulization to facilitate the recovery of children.