Gangkak Goto, Yadav Sher Singh, Tomar Vinay, Vyas Nachiket, Jain Deepak
Department of Urology and Renal Transplantation, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, 302004, India.
Pediatr Surg Int. 2016 Jun;32(6):609-14. doi: 10.1007/s00383-016-3876-3. Epub 2016 Feb 15.
Holmium:yttrium-aluminum-garnet (Ho:YAG) laser and Pneumatic cystolithotripsy (CL) are the most widely practiced transurethral procedures for treatment of pediatric bladder stones. The aim of our study was to compare the safety and efficacy of Ho:YAG laser CL and pneumatic CL in the treatment of pediatric bladder stones.
In this prospective randomized study from January 2012 to April 2015, 25 male children with bladder stones <3 cm were consecutively randomized into two treatment groups: group A (pneumatic CL) consisted of 13 patients and group B (Ho:YAG CL) consisted of 12 patients. Operative time, duration of stay and complications were recorded. Patients were followed up prospectively.
The mean operative time was significantly lower in group B (25.6 vs. 31.6 min) for stones <1.5 cm (p = 0.040). However, for stones between 1.5 and 3 cm in size, the mean operating times were similar in both the groups (49.4 min in Ho:YAG vs. 44.6 min in pneumatic, p = 0.40). There was no difference in complication rates and hospital stay in both the groups. No major complications were seen in both the groups.
We found that Ho:YAG CL was more effective than pneumatic CL for treating bladder stones smaller than 1.5 cm.
钬：钇铝石榴石（Ho:YAG）激光和气压弹道碎石术（CL）是治疗小儿膀胱结石最常用的经尿道手术。我们研究的目的是比较Ho:YAG激光碎石术和气压弹道碎石术治疗小儿膀胱结石的安全性和有效性。
在这项2012年1月至2015年4月的前瞻性随机研究中，25名膀胱结石小于3厘米的男性儿童被连续随机分为两个治疗组：A组（气压弹道碎石术）由13名患者组成，B组（Ho:YAG激光碎石术）由12名患者组成。记录手术时间、住院时间和并发症情况。对患者进行前瞻性随访。
对于小于1.5厘米的结石，B组的平均手术时间显著低于A组（25.6分钟对31.6分钟，p = 0.040）。然而，对于大小在1.5至3厘米之间的结石，两组的平均手术时间相似（Ho:YAG组为49.4分钟，气压弹道组为44.6分钟，p = 0.40）。两组的并发症发生率和住院时间没有差异。两组均未出现重大并发症。
我们发现，对于治疗小于1.5厘米的膀胱结石，Ho:YAG激光碎石术比气压弹道碎石术更有效。
