To evaluate the clinical safety and efficacy of using the visual puncture micro-percutaneous nephrolithotomy to treat the mid and distal calculi in children.

From May 2017 to December 2019, 25 children patients with mid and distal ureteric calculi were enrolled into this retrospective study. There were16 males and 9 femals (age range from 2 to 12 years) who were diagnosed by colour doppler ultrasound, CTU, et al. The average stone size was (12±6) mm in diameter (range from 5 to 21 mm). 23 cases got stones in the unilateral ureter and 2 cases in the bilateral ureters, 10 cases in the mid ureter, 15 cases in the distal ureter. 6 cases received ESWL and 3 cases received ureteroscopic lithotripsy, but they were failed. In the lithotomy position, the visual puncture micro-percutaneous nephrolithotomy linked with 0.9% sodium chloride was applied to enter into ureter through urethra. Holmium laser was used for lithotripsy.

All the 25 patients were operated successful onestage. The operation time was 15-50 min (32±10) min. All patients were recovery and discharged from hospital 4-7 (6) days later. No calculi moved up and escaped. Serious irritative symptoms of bladder occurred in 2 patients who recovered after pulled out the catheter. Fever (T>38.5℃) occurred in 2 patients who, and they became normal by changed sensitive antibiotic. No severe complications such as ureteral perforation and extravasation occurred. All patients were rechecked by ultrasound and KUB 3 days later, the stone clearance rate was 88%. One month later ultrasound was rechecked, no stone was residual, the stone clearance rate was 100%.

As a worth promoting treatment for the mid and distal calculi in children, the visual puncture micro-percutaneous nephrolithotomy is safe, minimally invasive, and effective.