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Treatment of renal stones in infants: comparing extracorporeal shock wave lithotripsy and mini-percutaneous nephrolithotomy

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Abstract

The objective of the study is to compare the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) and mini-percutaneous nephrolithotomy (MPCNL) in treating renal stones sizing 15–25 mm in infants <3 years. Forty-six infants with renal stones sizing 15–30 mm were treated by either ESWL (22 renal units in 22 infants) using Dornier compact delta lithotripter or MPCNL (25 renal units in 24 infants) using 14F–18F renal access under general anesthesia. The operation time, stone-free rate, re-treatment rate, and complications between the two groups were compared with the χ2, Mann–Whitney U, and Student’s t tests. No significant differences in mean age and stone size were observed between the two groups. The 1- and 3-month postoperative stone-free rates were 84 and 96 % in MPCNL group and were 31.8 and 86.4 % in ESWL group. The re-treatment and complication rates were significantly higher in ESWL group than in MPCNL group (50 vs. 12 %, P = 0.004; 16.0 vs. 45.5 %, P = 0.028). The stone recurrence rate was similar between the two groups. No significant changes of serum creatinine (Cr) level and glomerular filtration rate were observed in both groups. In conclusion, MPCNL is an effective and feasible alternative monotherapy for large renal stones (15–25 mm) in infants, with a higher stone-free rate and a lower complication rate when compared with ESWL.

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Authors and Affiliations

  1. Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, 1# Kangda Road, Haizhu District, Guangzhou, 510230, China

    Guohua Zeng, Zhijian Zhao, Wenqi Wu, Zhigang Zhao & Wen Zhong

  2. Guangdong Key Laboratory of Urology, Guangzhou Guangdong Province China, 1# Kangda Road, Haizhu District, Guangzhou, 510230, China

    Guohua Zeng, Zhijian Zhao, Wenqi Wu, Zhigang Zhao & Wen Zhong

  3. Department of Urology, Xinhua Hospital, Shanghai Jiaotong University, 1665#, Kongjiang Road, Yangpu District, Shanghai, 200092, China

    Jianye Jia

Authors
  1. Guohua Zeng
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  2. Jianye Jia
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  3. Zhijian Zhao
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  4. Wenqi Wu
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  5. Zhigang Zhao
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  6. Wen Zhong
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Correspondence to Guohua Zeng.

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Guohua Zeng and Jianye Jia contributed equally to this work as co-first authors.

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Zeng, G., Jia, J., Zhao, Z. et al. Treatment of renal stones in infants: comparing extracorporeal shock wave lithotripsy and mini-percutaneous nephrolithotomy. Urol Res 40, 599–603 (2012). https://doi.org/10.1007/s00240-012-0478-y

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  • DOI: https://doi.org/10.1007/s00240-012-0478-y

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