Chedgy Edmund C P, Griffin Stephen J, Dyer Jon P, Somani Bhaskar K
Department of Paediatric Urology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Urol Int. 2015;95(3):320-3. doi: 10.1159/000380857. Epub 2015 Mar 21.
The use of ureteroscopy in treating paediatric stone disease has risen in recent years. We retrospectively reviewed the results of ureteroscopic stone management for our regional paediatric stone service.
Between April 2010 and October 2013, consecutive patients undergoing ureteroscopy and stone fragmentation were identified. Data were recorded from electronic records for patient demographics, pre-operative assessment, stone characteristics, and intra- and post-operative complications.
Twenty-one patients (mean age 8.6 years; range: 1.4-16) had 32 procedures in our series (13 males and 8 females). Five (24%) had a metabolic abnormality and 8 (38%) had an anatomical abnormality. The mean initial stone size was 9.6 mm (range: 5-20) and 10 were left sided. Of the 32 procedures, 18 (56%) had a pre-operative stent. A positive pre-operative urine culture was seen in 4 (13%). CT was used in 6 (19%) with the rest having a combination of USS and/or plain KUB. Of these 21 patients, 13 (62%) were stone free after the first procedure, 17 (81%) after a second and 20 (95%) after a third (mean 1.5 procedures/patient). One patient with a 6-mm residual fragment chose to have surveillance. Eighteen (50%) had post-operative stent insertion. The mean length of stay was 1.5 days (range: 0-5). A minor complication (Clavien 1) was observed in 1 patient. No other complications were recorded.
Ureteroscopy for stone disease in children is feasible with a low complication rate and high stone-free rate.
近年来，输尿管镜在治疗小儿结石病中的应用有所增加。我们回顾性分析了我们地区小儿结石治疗服务中输尿管镜下结石处理的结果。
2010年4月至2013年10月期间，对连续接受输尿管镜检查和结石破碎术的患者进行了识别。从电子记录中记录患者的人口统计学资料、术前评估、结石特征以及术中和术后并发症。
我们的系列研究中有21例患者（平均年龄8.6岁；范围：1.4 - 16岁）接受了32次手术（13例男性和8例女性）。5例（24%）有代谢异常，8例（38%）有解剖异常。初始结石平均大小为9.6毫米（范围：5 - 20毫米），10例位于左侧。在32次手术中，18例（56%）术前放置了支架。4例（13%）术前尿培养呈阳性。6例（19%）使用了CT，其余患者则联合使用了超声和/或腹部平片加静脉肾盂造影。在这21例患者中，13例（62%）首次手术后结石清除率达到100%，17例（81%）第二次手术后达到100%，20例（95%）第三次手术后达到100%（平均每位患者1.5次手术）。1例有6毫米残余结石碎片患者选择进行观察。18例（50%）术后放置了支架。平均住院时间为1.5天（范围：0 - 5天）。1例患者出现轻微并发症（Clavien 1级）。未记录到其他并发症。
输尿管镜治疗儿童结石病是可行的，并发症发生率低，结石清除率高。
