Minimally invasive pereutaneous nephrolithotomy with pneumatic lithotripsy for treatment of pediatric upper urinary calculi

Objective To investigate the effect and safety of minimally invasive percutaneous nephrolithotomy(MPCNL) in treatment of upper urinary tract calculi in children.Methods Retrospecitvely analyzed 39 cases(43 sides) with upper urinary tract calculi from January 2004 to April 2013,they were all received minimally invasive percutaneous nephrolithotomy with pneumatic lithotripsy(pneumatic lithotripsy and holmium laser).Under the ipsilateral ureter retrograde ureteroscopy 4-6F indwelling ureteral catheter,puncture percutaneous renal target calyx established channels under B-type ultrasound guidance,pneumatic lithotripsy and holmium laser lithotripsy,X-ray films or B-type ultrasound were used to evaluate stone expulsion after operation.Results One session MPCNL were successfully performed in all children.The operation time ranged from 50 to143(82.0±9.0) min,the stone clearance rate was 90.7%(39/43).Severe complications such as pneumothorax,intraoperative injury to adjacent organs did not occurred in all patients.Thirty-seven patients were followed up for 3-12 months,children with hydronephrosis were not aggravated,the kidney function is improved after operation,no complications occurred.Conclusion Minimally invasive percutaneous nephrolithotomy with fewer traumas,less complications,the stone clearance rate was high;it is safe and reliable to treat upper urinary tract calculi in children.