Comparative Study Of Super-mini Percutaneous Nephrolithotomy And Retrograde Intrarenal Surgery In Children With Kidney Stones

Objective: Through the comparative study of the treatment of renal calculi in children less than 2cm by using the Super-mini Percutaneous Nephrolithotomy and r Retrograde intrarenal surgery,we can provide the basis for clinicians to choose the cost-effective surgical methods.Methods:A retrospective study of 110 children with kidney stones treated in the Urology Department of the People’s Hospital of Xinjiang Uygur Autonomous Region from January2016 to April 2019.The maximum diameter of each child was ≤2 cm.Soft mirror treatment,69 cases were treated with ultramicrochannel percutaneous nephroscopy,comparing the success rate of first-stage operation,operation time,postoperative hemoglobin decline value,stone clearance rate,postoperative complications,and postoperative hospital stay,Postoperative DJ tube retention rate and medical costs and other indicators.Results: The average diameter of stones was 10.89 ± 3.74 mm in the RIRS group and 12.08 ±3.0mm in the SMP group.There was no significant difference between the two groups(P >0.05).By statistical calculation(P > 0.05),there was no significant difference between the two groups in the gender,age,BMI,the largest diameter of stones,the ratio of multiple stones,the CT value of stones,and the positive rate of preoperative urine culture,which was comparable.The success rate of the first-stage surgery in the RIRS group was 97.6%(40/41);the average operation time was 81.50±37.64min;40 children under the first-stage surgery,the average postoperative hemoglobin decrease was 8(7,11)g / L,postoperative complications The incidence rate was 25%(10/40);the average postoperative hospital stay was 4.1±2.1days;the postoperative DJ tube retention rate was 100%;the average total medical cost was25.54±4.67 thousand yuan;the first-stage stone removal rate was 77.5%(31/40)40),the final clearing rate after 3 months is 87.5%(35/40).The success rate of the first-stage operation in the SMP group was 100%(69/69);the average operation time was 53.90±13.63 minutes;69 patients with the first-stage operation had an average postoperative hemoglobin decrease of 9(3,16)g / L.The complication rate was 18.8%(13/69);the average postoperative hospital stay was 4.9 ± 2.8 days;the postoperative DJ tube retention rate was 24.6%;the average total medical cost was 19.75±5.36 thousand yuan,and the first-stage stone removal rate was 85.5%(59/69),the final clearing rate after 3 months is 94.7%(63/69).Through statistical calculation and analysis,there was no significant difference between the two groups in the first-stage surgical success rate,first-stage clearing rate,final clearing rate,hemoglobin decline value,total postoperative complication rate and postoperative hospital stay(P> 0.05).There were significant differences between the two groups in operation time,intraoperative blood loss,postoperative DJ tube retention rate and total medical expenses(P <0.05).Conclusion: It is safe and effective to treat children with renal calculi ≤2cm by RIRS and SMP.However,SMP has the advantages of short operation time,less times of hospitalization and anesthesia,low total medical cost and no need of conventional DJ tube before operation.It is a high cost-effective operation.