Jhanwar Ankur, Bansal Ankur, Sankhwar Satyanarayan, Kumar Manoj, Kanodia Gautam, Prakash Gaurav
King George Medical University, Lucknow, Uttar Pradesh, India.
Int Braz J Urol. 2016 Nov-Dec;42(6):1178-1182. doi: 10.1590/S1677-5538.IBJU.2016.0211.
To analyse outcomes of holmium laser and pneumatic lithotripsy in treatment of lower ureteric calculus in pediatric patients.
Prospective study conducted between August 2013 and July 2015. Inclusion criteria were lower ureteric calculus with stone size ≤1.5cms. Exclusion criteria were other than lower ureteric calculus, stone size ≥1.5cms, congenital renal anomalies, previous ureteral stone surgery. Patients were divided into two groups. Group A underwent pneumatic and group B underwent laser lithotripsy procedure. Patient's baseline demographic and peri-operative data were recorded and analysed. Post operatively X-ray/ultrasound KUB (Kidney, ureter and bladder) was performed to assess stone free status.
A total of 76 patients who met the inclusion criteria to ureteroscopic intracorporeal lithotripsy were included. Group A and B included 38 patients in each. Mean age was 12.5±2.49 in Group A and 11.97±2.74 years in Group B respectively (p=0.38). Overall success rate was 94.73% in Group A and 100% in Group B, respectively (p=0.87).
Holmium Laser lithotripsy is as efficacious as pneumatic lithotripsy and can be used safely for the endoscopic management of lower ureteric calculus in pediatric patients. However, holmium laser requires more expertise and it is a costly alternative.
分析钬激光和气压弹道碎石术治疗小儿输尿管下段结石的疗效。
2013年8月至2015年7月进行的前瞻性研究。纳入标准为输尿管下段结石且结石大小≤1.5厘米。排除标准为非输尿管下段结石、结石大小≥1.5厘米、先天性肾脏异常、既往输尿管结石手术史。患者分为两组。A组接受气压弹道碎石术,B组接受激光碎石术。记录并分析患者的基线人口统计学和围手术期数据。术后行X线/超声腹部平片(肾脏、输尿管和膀胱)检查以评估结石清除情况。
共有76例符合输尿管镜体内碎石术纳入标准的患者被纳入研究。A组和B组各有38例患者。A组平均年龄为12.5±2.49岁,B组平均年龄为11.97±2.74岁(p = 0.38)。A组总体成功率为94.73%,B组为100%(p = 0.87)。
钬激光碎石术与气压弹道碎石术疗效相当,可安全用于小儿输尿管下段结石的内镜治疗。然而,钬激光需要更多专业技术,且是一种成本较高的选择。