title: Ultrasound-guided mini-percutaneous nephrolithotomy in patients aged less than 3 years: the largest reported single-center experience in China.
abstract: To investigate the efficacy and safety of mini-percutaneous nephrolithotomy (mini-PCNL) under total ultrasonography in patients aged <3 years.
  
  
  METHODS
  We reviewed 56 patients (67 renal units) aged <3 years between August 2006 and December 2012 in our units, including 31 renal units with a single stone, 6 with staghorn stones, 10 with upper ureteral stones, and 20 with multiple stones. The mean age of the patients was 24 (range 6-36) months and the mean maximum stone diameter was 18.9 (range 10-32) mm. The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12-16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope. Forty-five patients with unilateral stones underwent a single procedure, and 11 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.9 (range 2.1-5) min, the mean operative time was 36.8 (range 20-88) min, the mean decrease in hemoglobin concentration was 8.7 (2-15) g/L, and the stone-free rate at hospital discharge was 92.5%. The mean postoperative hospital stay was 7.1 (range 3-13) days. Post-procedure complications included fever (>38.5 °C) in four patients, and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed. Ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.
authors.affiliation: Department of Urology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xiao
authors.affiliation: Department of Urology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Urology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Urology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, China.
authors.forename: Song
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of O.R., Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Urology, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing, China. lijianxing2015@163.com.|, No.168, Litang Road. Dongxiaokou Town, Changping District, 102218, Beijing, China. lijianxing2015@163.com.
authors.forename: Jianxing
authors.initials: J
authors.lastname: Li
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D007902:Length of Stay; D017602:Lithotripsy, Laser / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D000069856:Staghorn Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D020709:Ureteroscopes
keywords: Calculi; Infant; Kidney; Percutaneous nephrolithotomy; Ultrasonography