Minimally invasive percutaneous nephrolithotomy for treatment of upper urinary calculi in children

Objective:To evaluate the clinical effect and safety of minimally invasive percutaneous nephrolithotomy(mPCNL)for the treatment of upper urinary calculi in children.Method:We retrospectively reviewed the clinical records of 12 cases of children who underwent percutaneous nephrolithotomy procedures from February 2008 to May 2011.All patients received retrogradeplacement of F3-F5 ureteral catheter under the ureteroscope,with the help of B type ultrasonography,a F16 percutaneous working channel for ureteroscope was established.Renal stones were tried to fragment and extract one stage under a F8.0/9.8 ureteroscope by using the fourth generation Swiss Litho Clast Master.Result:A F16 percutaneous renal access was successfully established in all patients.The stones were cleared out completely in 10 out of 12 cases.a 83.3% stone-free rate was achieved using percutaneous nephrolithotomy monotherapy.Other 2 cases had a residual stones,they underwent extracorporeal shock-wave lithotripsy(ESWL)and lithagogue medicine.The operation duration was 30-116 minutes,averaged 53 minutes.No complications such as blood transfusion,pneumothorax or injury of intra-abdominal organs were recorded.All patients were followed up for at least 3-24 months.Renal function test got a better result.Uronephrosis relieved.No complications such as palindromia of lithiasis,ureterostenosis,hydronephrosis or renal inadequacy were recorded.Conclusion:Treatment of children's upper urinary tract stone by mPCNL has the advantages of high efficiency,reliability,safety,mini-invasion,less haemorrhage and rapid recovery.It should be the first choice for children's upper urinary tract stone at present.