| Objective To investigate factors affecting residual stones in pediatric patients with the upper urinary calculi undergoing minimally invasive percutaneous nephrolithotomy and evaluate the stone-free rate before the operation.Methods A total of 240 children underwent MPCNL to remove the upper urinary calculi in People’s Hospital of Xinjiang Uygur Autonomous Region during the period of January 2009 to November 2014 were analyzed retrospectively. Pediatric patients were divided into two groups by the stone-free rate after the first operation: those who were stone-free after the first operation(n=202) as the control group and those who were residual stones(n=38) as residual stones observation group. Then the clinical data were statistically analyzed and find out risk factors which lead to residual stone.Results The stone-free rate after primary MPCNL was 84.2%( 202/240).On univariate analysis showed that stone size(P=0.001),stone location(P=0.014) and number of stones(P=0.005) were significant factors which could affect residual stones between the 2 groups, while did not relate with gender, age, stone side, urinary irritation symptom, hematuria, renal colic, preoperative infection and the degree of hydronephrosis(P>0.05).Then on multivariate analysis found that stone size(OR=2.593,95%CI:1.228~5.475),stone location(OR=2.674,95%CI:1.290~5.540)and number of stones(OR=2.397,95%CI:1.145~5.019)were independent predictors of the surgical outcome.Conclusion Stone size, stone location and number of stones are significant factors affecting residual stones in pediatric patients with the upper urinary calculi undergoing minimally invasive percutaneous nephrolithotomy. According to the the clinical features of pediatric patients, we can chose suitable management of upper urinary tract calculi. |
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