Clinical analysis of mini-percutaneous nephrolithotomy in 39 infants with upper urolithiasis in Hotan region, Xinjiang Uyger Autonomous Region

Abstract

Objective To evaluate the effectiveness and safety of mini-percutaneous nephrolithotomy in treating infant upper urolithiasis. Methods Retrospective analysis of 39 cases of infant upper urolithiasis treated with mini-percutaneous nephrolithotomy between March 2015 to January 2016 in Hotan Region People′s Hospital was performed, with the age of(1.8±1.2) years(6 months to 3 years old), including 21 male and 18 female.Exclusion of inherent anatomical abnormalities of urinary tract was performed by pre-operation image screening.A total of 46 renal were treated with mini-percutaneous nephrolithotomy, including 7 cases of bilateral urolithiasis.Urinary tract radiograph or ultrasonagraphy, operation time, hemoglobin(Hb) decrease, electrolyte changes and stone clearance were recorded after operation. Results All scheduled mPCNLs were performed snccessfully.The stone burden was(3.1±0.9) cm(ranging from 2.0 to 4.0 cm) in 46 renal units with a the pre-operative Hb(114.0±22.1) g/L (76 -137 g/L), including 3 cases Hb less than 80 g/L and 3 cases of serum albumin less than 25 g/L, and the weight of 14 patients was less than the standard weight.Access was gained from medium posterior calyx in 39 cases and upper calyx in 6 cases, and double access pathway was performed in 1 case who with parallel calyx urolithiasis.The operation time was 37-65 min, and the mean operation time was 52 min.Post-operative stone clearance was 78.26%.There were 3 cases(6.25%) grade Ⅰ and 5 cases(10.87%) grade Ⅱ complications including 3 cases(6.52%) with infectious complication and 2 cases(14.35%) with blood transfusion.No grade Ⅲ complications were observed. Conclusions Single mPCNL is recommended as a standard treatment for infant upper uroliathiasis with more carefully and systematic pre-operation evaluation due to their poor tolerance. Key words: Lithology; Urinary system; Percutaneous nephrolithotomy; Infant