A retrospective cohort study: evaluating the efficacy of standard versus tubeless percutaneous nephrolithotomy (PCNL) in pediatric patients up to 18 years old

IF 2 2区医学 Q2 UROLOGY & NEPHROLOGY

Urolithiasis Pub Date : 2024-04-18 DOI:10.1007/s00240-024-01540-z

Kian Kiani, Shahriar Amirhasani, Seyed Habibollah Mousavi-bahar, Abbas Moradi

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引用次数: 0

Abstract

Percutaneous nephrolithotomy (PCNL) is an endourological method applied as the standard or tubeless method for kidney stone treatment. In a retrospective cohort study, 88 surgery units involving 75 children up to 18 years old with kidney stones who underwent the surgery for 8 years in Shahid Beheshti and Boo-ali hospitals in Hamadan with one of the two methods of standard or tubeless PCNL were evaluated and compared considering the success rate of operation, hemoglobin, hematocrit drop, need for medications, need for blood transfusion, duration of surgery, and the length of hospital stay. Among the 88 units studied, 47 cases were operated with the standard PCNL and 41 cases by tubeless method. In children operated by standard and tubeless PCNL, the complete success rate of operation was 87.2% and 100% (P = 0.006), the need for blood transfusion was 2.1% and 0% (P = 1.00), the need for opioids was 27.7% and 14.6% (P = 0.134), the decrease in hemoglobin was − 1.82 ± 0.94 and -1.30 ± 0.98 mg/dl (P = 0.024), the decrease in hematocrit was − 5.40 ± 2.66 and -3.52 ± 3.11 mg/dL (P = 0.003), the mean surgery duration was 109.30 ± 53.27 and 101.46 ± 31.92 min (P = 0.414), the duration of postoperative hospitalization was 3.38 ± 1.76 and 2.46 ± 1.27 days (P = 0.007), and the frequency of fever was 23.4% and 7.3% (P = 0.04), respectively. The success rate of kidney stone surgery in children with the tubeless PCNL is higher than the standard method, and its complications are lower.

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回顾性队列研究：评估 18 岁以下儿科患者接受标准与无管经皮肾镜取石术 (PCNL) 的疗效

经皮肾镜取石术（PCNL）是一种内窥镜方法，是治疗肾结石的标准或无管方法。在一项回顾性队列研究中，研究人员对哈马丹市 Shahid Beheshti 医院和 Boo-ali 医院 88 个手术单位的 75 名 18 岁以下肾结石患儿进行了评估，这些患儿在 8 年中接受了标准 PCNL 或无管 PCNL 两种方法中的一种手术，并对手术成功率、血红蛋白、血细胞比容下降、用药需求、输血需求、手术时间和住院时间进行了比较。在所研究的 88 个病例中，47 例采用标准 PCNL 手术，41 例采用无管手术。在采用标准PCNL和无管PCNL手术的患儿中，手术完全成功率分别为87.2%和100%（P = 0.006），输血需求分别为2.1%和0%（P = 1.00），阿片类药物需求分别为27.7%和14.6%（P = 0.134），血红蛋白降幅分别为- 1.82 ± 0.94和-1.30 ± 0.98 mg/dl（P = 0.024），血细胞比容降幅分别为- 5.40±2.66和-3.52±3.11 mg/dL（P=0.003），平均手术时间分别为（109.30±53.27）和（101.46±31.92）min（P=0.414），术后住院时间分别为（3.38±1.76）天和（2.46±1.27）天（P=0.007），发热频率分别为23.4%和7.3%（P=0.04）。与标准方法相比，无管 PCNL 儿童肾结石手术的成功率更高，并发症更少。

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来源期刊

Urolithiasis UROLOGY & NEPHROLOGY-

CiteScore

4.50

自引率

6.50%

发文量

期刊介绍： Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.