经皮肾镜治疗儿童复杂性肾结石的疗效及并发症防治OA北大核心

Objective To summarize the efficacy of percutaneous nephrolithotomy(PCNL)in the treat-ment of pediatric complex renal stones and share expriences in managing complications.Methods A retro-spective analysis was conducted on clinical data from 144 children with complex renal stones treated with PCNL at the Department of Urology,Hunan Children's Hospital(Center of Prevention and Treatment of Pediatric Uro-lithiasis,International Alliance of Urolithiasis)between June 2017 and December 2021.The cohort included 100 boys and 44 girls with a mean age of 7.3±4.2 years(range:0.4-18.0 years).Single stones were ob-served in 38 cases,while 106 cases had multiple stones.The mean stone diameter was 2.3±0.5 cm(range:1.5-3.8 cm),and all single stones exceeded 2 cm in diameter.Preoperative evaluations included urinary sys-tem ultrasound,kideny ureter bladder(KUB)X-rays,or CT scans to assess stone and anatomical conditions.Follow-ups ranged from 1 to 7 years,during which surgical time,outcomes,intraoperative and postoperative com-plications,and their management were recorded.Results The mean surgical time was 62.7±11.3 minutes(range:41-94).At 1-month postoperative review,128 cases achieved complete stone clearance(clearance rate:88.9％).At three month,131 cases achieved complete clearance(clearance rate:90.1％).Postoperative complications occurred in 16 cases(11.1％),classified according to the Clavien-Dindo system:Grade Ⅰ in 1 case,Grade Ⅱ in 13 cases,and Grade Ⅲ in 2 cases.No Grade Ⅳ or higher complications were reported.Conclusions PCNL is highly effective in treating pediatric complex renal stones,offering high stone clearance rates.It is currently the preferred treatment method,with manageable complications.Proper and timely interven-tions for complications can prevent major risks.