Comparative Analysis Of The Efficacy And Recurrence Of Open Stone Surgery And Percutaneous Nephrolithotomy In The Treatment Of Renal Calculi In Children

Objective: To compare the efficacy and recurrence of Open stone surgery(OSS)and Percutaneous nephrolithotomy(PCNL)in the treatment of renal calculi in children.Methods: The clinical data of 74 cases of OSS and 70 cases of PCNL in the treatment of children’s renal calculi were analyzed retrospectively.According to guy’s classification of renal calculi,the postoperative complications,first-stage stone removal rate,postoperative hospital stay,stone recurrence rate,reoperation rate and hydronephrosis remission rate were analyzed.Results: There was no significant difference about the guy’s classification between the two groups(P=0.474).The incidence of postoperative fever was 12.16% in OSS group and 17.14% in PCNL group,and there was no significant difference between the two groups(P=0.397).The incidence of postoperative incision infection was 1.35% in OSS group and 0% in PCNL group,and there was no significant difference between the two groups(P=0.329).The incidence of postoperative bleeding was 0% in OSS group,and the incidence of postoperative bleeding was 1.43% in PCNL group,and there was no significant difference between the two groups(P=0.302).The stone clearance rate of OSS group was 95.9%(71/74)and PCNL group was 87.5%(60/70),and the difference between the two groups was statistically significant(P=0.032).The average hospitalization days in OSS group and PCNL group were 9.36±4.19 days and 7.80±3.26 days respectively,and there was significant difference between the two groups(P=0.025).In OSS group,the cumulative recurrence rate of stones 1year,2year and 5year after operation were 5.40%,8.10% and 12.16%,respectively.The cumulative recurrence rate of stones in PCNL group were 11.40%,20% and 25.71%,respectively.There was no significant difference between the two groups 1 year after operation,(P=0.191).There was a significant difference between the two groups in the cumulative recurrence rate of 2 and 5 years after operation(P<0.05).There was no significant difference in re-operation rate at 1 year after operation between the two groups(P=0.216).The re-operation rate of OSS group at 2 and 5 year after operation was 5.40%(4/74)and 9.45%(7/74),respectively.The rate of re-operation in PCNL group were 15.71%(11/70)and 21.43%(15/70),respectively,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference in the remission rate of hydronephrosis between OSS group and PCNL group(P>0.05).Conclusion: Compared with PCNL,OSS has the advantages of high stone removal rate,low stone recurrence rate and low re-operation rate.