Advantage of color doppler ultrasonography guidence in mini percutaneous nephrolithotomy for pediatric patients

Abstract

Objective To evaluate the advantages of color doppler ultrasonography guidence in mini-invasive percutaneous nephrostolithotripsy(mPCNL) for pediatric patients.Methods From May 2006 to August 2011,a total of 165 pediatric cases with upper urinary stone,who were treated by mPCNL with F12-F16 access route,were respectively reviewed.All procedures were under the guidance of color doppler ultrasonography,and the pneumatic lithotripsy and/or EMS ultrasound lithotripsy were used to disintegrate the stones.Results In one-stage mPCNL,The average length of the stones was ( 15.82 ±6.31 ) mm,all 165 cases were treated,during which percutaneous renal access was successfully established under color doppler ultrasound guidance and stones were fragmentated.The mean duration of renal access establishment was (11.7 ± 5.3 ) min.The one-stage stone free rate was 95.2％(157/165) with the operation time of (42.6 ± 20.1 ) min.The postoperative hemoglobin aud hematocrit decline were observed in 69.7 ％ ( 115/165 ) of the cases with the value of 2.67 g/L and 2.21％ respectively when compared with their preoperative counterpart. Infection rate related to operation was 23.03％ ( 38/165 ),which was demostrated by durative or iterative fever more than 48 hours.No perioperative bleeding was recorded,and no transfusion was required.No ease experienced perirenal organ injury.Conclusions Using color doppler ultrasound guidance during m-PCNL resulted in safe and effective therapeutic method for upper urinary stone,and can be considered as measures of choice for guidence of mPCNL in pediatric patients. Key words: Pediatric urinary stones;  Percutaneous nephrolithotomy;  Doppler ultrasonography