Ainiwaer Aierken,Xu Hai,Kahaerman Silamu,et al.Curative comparison of three mini-invasive surgical treatments for 10-20 mm kidney calculi in children[J].Journal of Clinical Pediatric Surgery,,():853-857.[doi:10.3760/cma.j.cn101785-202412055-009]
Curative comparison of three mini-invasive surgical treatments for 10-20 mm kidney calculi in children
- Keywords:
- Kidney Calculi; Surgical Procedures; Operative; Child
- Abstract:
- Objective To compare the efficacies of super mini-percutaneous nephrolithotomy (SMP), mini-percutaneous nephrolithotomy (mPCNL) and retrograde intrarenal surgery (RIRS) for 10-20 mm kidney calculi in children. Methods From January 2015 to December 2019, the relevant clinical data were retrospectively reviewed for 128 children aged < 14 year with 10-20 mm kidney calculi.SMP group underwent lithotripsy (F12-14)(n=43) while mPCNL group lithotriptic extraction (F14-16)(n=45) and RIRS group ureteral soft scope lithotripsy (n=40).Operative duration, hospitalization stay, immediate postoperative hemoglobin decline, calculi clearance rate, postoperative catheterization rate and complication rate were compared among three groups. Results Length of hospitalization stay in SMP group was (6.9±1.1) day.It was significantly shorter than that in mPCNL group (7.9±0.9) day and RIRS group (7.5±1.3) day.The difference was statistically significant (P < 0.05).The rate of complete distubation in SMP group (72.1%, 31/43) was significantly higher than that in mPCNL group (48.9%, 22/45) and RIRS group (0%, 0/40).And the difference was statistically significant (P < 0.001).Operative duration of RIRS group was (31.6±10.9)min and it was significantly shorter than that of mPCNL group (44.1±17.8) min.And the difference was statistically significant (P=0.001).However, no statistically significant difference existed between RIRS and SMP groups (40.5±19.1) min (P>0.05).Rate of ureteral stenting in RIRS group (100%, 40/40) was significantly higher than that in SMP group (23%, 10/43) and mPCNL group (26.7%, 12/45).And the difference was statistically significant (P < 0.001).Rate of indentable nephrostomy tube in mPCNL group (24%, 11/45) was higher than that in SMP group (4.7%, 2/43) and RIRS group (0%, 0/40).And the difference was statistically significant (P < 0.001).No significant difference existed in calculi clearance rate or immediate hemoglobin decline rate at Month 3 post-operation among 3 groups (P>0.05). Conclusions SMP, mPCNL and RIRS are all safe and efficacious for 10-20 mm kidney calculi in children.However, SMP offers the advantages of shorter hospitalization stay and a higher tube-free rate.RIRS group has short operative duration.
References:
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Memo
收稿日期:2024-12-20。
基金项目:“天山英才”医药卫生高层次人才培养计划项目(TSYC202301B078);新疆人工智能影像辅助诊断重点实验室开放课题项目(XJRGZN2024011)
通讯作者:加素尔·巴吐尔，Email: Jasurbatur@foxmail.com