Application of Doppler ultrasound-guided minimally invasive percutaneous nephrolithotomy in preschool children

Abstract

Objective To evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy(PCNL) with a intracorporeal pneumatic lithotripter in preschool children.Methods From March 2009 to March 2012,68 children with renal stones underwent Doppler ultrasound-guided percutaneous nephrolithotomy in this hospital.The average age was 4.2 years (ranging from 1.5 to 6 years).There were 2 staghorn calculi,18 multiple stones,5 bilateral stones,and 8 radiographically negative stones in this study.Doppler ultrasound-guided PCNL with minimal tract (14F,16F) were performed in all patients using a 9.8F Storz ureteroscope and pneumatic ballistic lithotriptor Swiss Lithoclast Master EMS(R).The intraoperative and postoperative findings were assessed.Results The mean operating time was (56.6 ± 15.2)min (ranging from 30 to 95 min).The overall success rate was 95.9％ with a second PCNL treatment in 6 cases.The postoperative mean hemoglobin was reduced by (12 ± 2.2)g/L.Fever was observed in 4 patients,urine leakage in 1,and bleeding in 1 who was cured by blood transfusion.No neighboring organs injury was observed.The mean hospital stay was (12.2± 3.4)days.Conclusions Doppler ultrasound-guided percutaneous nephrolithotomy can be applied safely to preschool children,providing the advantages of treatment for these patients without radiation exposure,massive blood loss,or injury of neighboring organs. Key words: Kidney calculi; Nephrostomy, percutaneous; Children; Ultrasound doppler