Zhang Bin,Wang Xiang.Comparison of efficacy and safety of percutaneous nephrolithotomy under ultrasonic versus X-ray guidance for complicated renal calculi in children[J].Journal of Clinical Pediatric Surgery,,19():683-687.[doi:10.3969/j.issn.1671-6353.2020.08.005]
Comparison of efficacy and safety of percutaneous nephrolithotomy under ultrasonic versus X-ray guidance for complicated renal calculi in children
- Keywords:
- Kidney Calculi/SU; Kidney Calculi/US; Kidney Calculi/RA; Child
- CLC:
- R692.4;R445.1;R814;R726.1
- Abstract:
- Objective To compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) under ultrasonic versus X-ray guidance for complicated renal calculi in children. Methods From July 2011 to July 2018, clinical data were retrospectively analyzed for 80 sides with complicated renal calculi undergoing PCNL, including 41 sides guided by X-ray and 39 sides guided by ultrasound. Preoperative general profiles, success rate of one-time skin-kidney channel establishment, number of failed puncture cases, perioperative complications and stone free rate (SFR) were compared. Results No significant inter-group difference existed in gender, age, sideness or stone size (P>0.05). Intraoperative ultrasound group was significantly better than X-ray group in success rate of one-time skin-kidney channel establishment (89.7% vs 70.7%, P=0.034). In X-ray group, 2 sides failed in the final puncture for terminating operation, 1 side had concurrent colon injury and 2 sides received perioperative blood transfusion. In two groups (X-ray/ultrasound), no statistically significant differences existed (P>0.05) in number of final puncture failure (2 vs 0), average operative duration (109.76±32.46 vs 109.26±74.68 min), intraoperative complications (1 vs 0), perioperative period blood transfusion (2 vs 0), average postoperative hospital stay (8.49±2.72 vs 8.23±1.78 d) or SFR (80.5% vs 76.9%). Conclusion PCNL guided by ultrasound is as safe and effective as guided by traditional X-ray for complicated renal calculi in children. Capable of completely avoiding the radiation exposure of surgeons and patients during PCNL surgery, it is worthy of further clinical popularization.
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Memo
收稿日期:2020-05-24。
通讯作者:王翔,Email:wangxiang3333@hotmail.com