Erkurt Bulent, Caskurlu Turhan, Atis Gokhan, Gurbuz Cenk, Arikan Ozgur, Pelit Eyup Sabri, Altay Bulent, Erdogan Firat, Yildirim Asif
Department of Urology, School of Medicine, Medipol University, Istanbul, Turkey,
Urolithiasis. 2014 Jun;42(3):241-5. doi: 10.1007/s00240-013-0636-x. Epub 2013 Dec 28.
The aim of the study is to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) to treat renal stones in preschool age (<7 years) children. From September 2005 to May 2013, a total of 65 children (31 boys and 34 girls) with 72 renal stones were treated using RIRS. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. In the presence of residual calculi >4 mm, a second-stage RIRS was performed. The pre-operative, operative and post-operative data of the patients were retrospectively analyzed. A total of 65 patients with a mean age of 4.31 ± 1.99 years (6 months-7 years) were included in the present study. The mean stone size was 14.66 ± 6.12 mm (7-30 mm). The mean operative time was 46.47 ± 18.27 min. In 5 (7.69%) patients, the initial procedure failed to reach the renal collecting system and ended with the insertion of a pigtail stent. The stone-free rates were 83.07 and 92.3% after the first and second procedures, respectively. Complications were observed in 18 (27.7%) patients and classified according to the Clavien system. Post-operative hematuria (Clavien I) occurred in 6 (9.2%) patients, post-operative urinary tract infection with fever (Clavien II) was observed in 10 (15.4%) patients, and ureteral wall injury (Clavien III) was noted in 2 (3%) patients. RIRS is an effective and safe procedure that can be used to manage renal stones in preschool age children.
本研究的目的是评估逆行性肾内手术（RIRS）治疗学龄前（<7岁）儿童肾结石的疗效和安全性。2005年9月至2013年5月，共有65例患有72颗肾结石的儿童（31例男孩和34例女孩）接受了RIRS治疗。当影像学检查未发现残留碎片时，患者被视为结石清除。若存在>4mm的残留结石，则进行二期RIRS。对患者的术前、术中及术后数据进行回顾性分析。本研究共纳入65例患者，平均年龄为4.31±1.99岁（6个月至7岁）。平均结石大小为14.66±6.12mm（7至30mm）。平均手术时间为46.47±18.27分钟。5例（7.69%）患者最初的手术未能进入肾集合系统，最终以置入猪尾支架结束。第一次和第二次手术后的结石清除率分别为83.07%和92.3%。18例（27.7%）患者出现并发症，并根据Clavien系统进行分类。6例（9.2%）患者出现术后血尿（Clavien I级），10例（15.4%）患者出现术后伴有发热的尿路感染（Clavien II级），2例（3%）患者出现输尿管壁损伤（Clavien III级）。RIRS是一种有效且安全的手术方法，可用于治疗学龄前儿童的肾结石。
