Clinical application of super-mini PCNL (SMP) in the treatment of upper urinary tract stones under ultrasound guidance

摘要

PurposeTo present the safety and efficacy of totally ultrasonography-guided Super-mini percutaneous nephrolithotomy (SMP) in the treatment of upper urinary tract stones both in children and adults.Patients and methodsWe carried out SMP in 104 patients (including 48 children and 56 adults) with upper urinary tract stones between June 2015 and February 2017. All steps of renal access were performed by ultrasonography. The lithotripsy was performed using either Holmium laser or pneumatic lithotripter. Perioperative and postoperative parameters along with operative data were recorded in detail.ResultsThe mean age of children and adult patients were 4.43.6 and 44.3 +/- 15.7years old, respectively. The stone burden was comparable for both groups (1.72 +/- 0.66 vs 1.74 +/- 0.56cm, p=0.852). Mean operation time was not significant different between two groups (p=0.052), while the mean haemoglobin drop in children was much lower in adult patients (6.3 +/- 6.9 vs 10.9 +/- 8.69, p=0.004). Both groups had similar SFRs in postoperative 1day and at 1-month follow-up (p=1.000, p=0.912). Mean hospital stay of children and adult patients was 2.3 +/- 0.8 and 2.2 +/- 0.76days (p=0.484). The total complication rate was significantly lower in two groups (p=1.000); none of the patients required blood transfusion.Conclusions Ultrasonography-guided SMP was a safe and effective treatment option for moderate-sized upper urinary tract stones, and has the advantage of preventing radiation hazard, especially for pediatric stone patients.