Jaidane Mehdi, Hidoussi Adnen, Slama Adel, Hmida Wissem, Ben Sorba Nabil, Mosbah Faouzi
Urology Department, Sahloul University Hospital, 4042, Sousse, Tunisia.
Pediatr Surg Int. 2010 May;26(5):501-4. doi: 10.1007/s00383-010-2572-y. Epub 2010 Feb 19.
To identify the factors involved in failure and post-operative complications of retrograde rigid ureteroscopy (URS) in the treatment of ureteric stones in children.
This is a retrospective study, including 33 children who underwent 34 rigid URS (one case bilateral) for obstructive ureteric stones over a period of 10 years. Patient age, sex, presenting symptoms, stone size and location, operative technique, surgical outcomes and complications were recorded. Ureteroscopy was done in a manner similar to that in adults. Statistical analysis was performed using the Mann-Whitney U, the Chi-square or Fisher's exact test.
There were 33 children (22 girls and 11 boys) with a mean age of 10.8 years (range 4-16 years) presenting 34 stones. The site of stones was pelvic in 24 cases (70.5%), iliac in 2 cases (6%) and lumbar in 8 cases (23.5%). The mean size of stones was 10.9 mm (5-22 mm). The success rate was 91%. There were no intraoperative complications. Post-operative complications rate was 21%. Factors associated with failure were size, localization of the stone, and delay of surgery. Factors associated with post-operative complications were size of the stone and operative time.
The rigid URS in children is a reliable and effective treatment option in the management of ureteric stones. Favorable factors for success of the procedure are pelvic stone and stone size <10 mm.
确定儿童输尿管结石逆行硬性输尿管镜检查（URS）失败及术后并发症的相关因素。
这是一项回顾性研究，纳入了10年间33例因梗阻性输尿管结石接受34次硬性URS（1例双侧手术）的儿童。记录患者年龄、性别、症状表现、结石大小及位置、手术技术、手术结果和并发症情况。输尿管镜检查采用与成人相似的方式进行。采用曼-惠特尼U检验、卡方检验或费舍尔精确检验进行统计学分析。
33例儿童（22例女孩和11例男孩），平均年龄10.8岁（4 - 16岁），共34枚结石。结石位于盆腔24例（70.5%），髂部2例（6%），腰部8例（23.5%）。结石平均大小为10.9 mm（5 - 22 mm）。成功率为91%。无术中并发症。术后并发症发生率为21%。与失败相关的因素为结石大小、位置及手术延迟。与术后并发症相关的因素为结石大小和手术时间。
儿童硬性URS是治疗输尿管结石的一种可靠且有效的选择。手术成功的有利因素为盆腔结石及结石大小<10 mm。
