Objective This study aims to evaluate the efficacy and safety of percutaneous nephrolithotripsy assisted by the needle-perc system without artificial hydronephrosis in the treatment of pediatric renal stones.Methods A total of 11 pediatric patients with renal stones treated underwent percutaneous nephrolithotripsy using the visualized needle-perc sys-tem were enrolled in Shannan People's Hospital during August 2021 to October 2022.The cohort included 7 males and 4 females aged 5-16 years,with 4 patients on the right side and 7 patients on the left side.Among them,5 patients had single renal pelvis stone and 6 patients had multiple calculi.The maximum mean diameter of calculi was(18.46±6.52)mm,with a mean CT value of(835.04±135.74)HU.All of them underwent percutaneous holmium laser lithotripsy un-der general anesthesia using a visualized needle-perc system,with the target calyx punctured by a 4.5Fr visualized punc-ture needle under ultrasound guidance.Subsequently,F16 percutaneous renal access was established,and lithotripsy was completed using a 550 μm holmium laser.After the operation,an F12 fistula was maintained in place,following a nee-dle-perc nephrolithotripsy procedure without the need for an indwelling nephrostomy tube.The operation duration,com-plications,hospital stay,and stone clearance post-surgery were evaluated.Results All children were successfully oper-ated,with 3 cases undergoing complete needle-perc nephrolithotripsy and 8 cases using a visualized needle-perc system.The average operation duration was(79.55±10.76)min,postoperative hemoglobin decreased by(10.09±5.25)g/L,and the average postoperative hospitalization period was(5.54±1.07)days.The stone clearance rate was 100％at the 4-week postoperative follow-up.No serious complications such as access loss,postoperative infection,severe bleeding,or injury to the kidney or adjacent organs during and after the surgery.Conclusion Needle-perc system assisted percutane-ous nephrolithotomy without artificial hydronephrosis is safe and effective in the treatment of pediatric renal stones.It demonstrates a low incidence of surgical complications and can achieve a satisfactory stone removal rate,making it suit-able for individualized pediatric renal stone treatment.Furthermore,this technique holds clinical significance in regions with a high incidence of kidney stones among children living on plateau.
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