Role of Minimally Invasive Percutaneous Nephrolithotomy Techniques-Micro and Ultra-Mini PCNL (<15F) in the Pediatric Population: A Systematic Review.
Role of Minimally Invasive Percutaneous Nephrolithotomy Techniques-Micro and Ultra-Mini PCNL (<15F) in the Pediatric Population: A Systematic Review.
复制标题
微创经皮肾镜取石技术 - 微型和超微型 PCNL (<15F) 在儿科人群中的作用：系统评价。
作者：
Patrick Jones;G. Bennett;O. Aboumarzouk;S. Griffin;B. Somani
介绍
小儿结石病的治疗具有挑战性，标准经皮肾镜取石术（PCNL）具有良好的结石清除率（SFR），但相关的并发症发生率较高。该技术的小型化导致微创PCNL技术的兴起，例如微型（<10 F）和超微型（<15 F）PCNL手术。我们的目的是对文献进行系统综述，以评价微创PCNL技术在儿科年龄组（<18岁）中的成功率和并发症发生率。
方法
进行了科克伦式检索，并访问了以下书目数据库：PubMed、Science direct、Scopus和Web of Science。这是根据系统性综述和荟萃分析（PRISMA）指南的首选报告项目进行的。
结果
共纳入14项研究（456例患者），包括8项关于微型PCNL（m-PCNL，n = 233）和6项关于超微型PCNL（UMP，n = 223）的研究。平均结石尺寸范围为12-16.5 mm（m-PCNL）和12-41 mm（UMP），总体SFR范围为80%-100%（m-PCNL）和85%-100%（UMP）。所有研究的总体并发症发生率为11.2%，UMP略高（13.9%）。术后肾绞痛或碎片梗阻仅见于m-PCNL，但与m-PCNL相比，UMP的外渗或肾盂肾盏穿孔和血尿发生率具有统计学意义。
结论
微型PCNL技术可提供高SFR，Clavien I/II并发症风险较小。肾道的大小似乎影响并发症的性质，随着肾道大小的增加，血尿和肾外渗增加。
INTRODUCTION
Management of pediatric stone disease is challenging, with standard percutaneous nephrolithotomy (PCNL) having a good stone-free rate (SFR), but with associated high complication rates. Miniaturization of this technique has led to the rise of minimally invasive PCNL techniques such as micro (<10F) and ultra-mini (<15F) PCNL procedures. Our objective was to perform a systematic review of the literature to evaluate the success and complication rates of minimally invasive PCNL techniques in the pediatric age group (<18 years).
METHODS
A Cochrane style search was performed and the following bibliographic databases were accessed: PubMed, Science direct, Scopus, and Web of Science. This was carried out in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
A total of 14 studies (456 patients), including 8 on micro-PCNL (m-PCNL, n = 233) and 6 on ultra-mini PCNL (UMP, n = 223), were included. Mean stone size ranged from 12-16.5 mm (m-PCNL) and 12-41 mm (UMP), and the overall SFR ranged from 80% to 100% (m-PCNL) and 85% to 100% (UMP). The overall complication rates for all studies were 11.2%, which was slightly higher for UMP (13.9%). Postoperative renal colic or fragment obstruction was only seen in m-PCNL, but there was a statistically significant rate of extravasation or renal pelvicaliceal perforation and hematuria for UMP compared with m-PCNL.
CONCLUSION
Miniaturized PCNL techniques can deliver high SFRs with a small risk of Clavien I/II complications. The size of tract seems to influence the nature of complications, with higher hematuria and renal extravasation with increasing tract size.
影响因子：
6.6
作者：
Dwyer, Moira E.;Krambeck, Amy E.;Bergstralh, Eric J.;Milliner, Dawn S.;Lieske, John C.;Rule, Andrew D.
通讯作者：
Rule, Andrew D.