Kirac Mustafa, Ergin Giray, Kibar Yusuf, Köprü Burak, Biri Hasan
Department of Urology, Koru Ankara Hospital , Ankara, Turkey .
J Endourol. 2018 Feb;32(2):100-105. doi: 10.1089/end.2017.0593. Epub 2018 Jan 15.
In the pediatric population, there have been significant improvements in the treatment of stones in recent years. Conventionally, ureteroscopy (URS) and/or retrograde intrarenal surgery are techniques performed with fluoroscopy. When using fluoroscopy, problems, including malignancy, may arise because of radiation exposure in the patient, physician, and operation room staff. The aim of this study is to evaluate the possibility of ureteroscopic treatment without fluoroscopy in children with ureteral and renal stones.
Between December 2010 and April 2017, pediatric patients were enrolled in this study. Data were retrospectively evaluated. URS was performed by the experienced surgeons in our center. Fluoroscopy was not routinely used during the operations. Demographic data, perioperative parameters, and success and complication rates were evaluated.
Sixty-seven renal units from 61 patients were operated on. URS without fluoroscopy was achieved in 95.0% of 61 patients (95.5% of 67 renal units). Three patients needed fluoroscopy during the operation. The mean stone size was 12.4 ± 5.3 mm, and the mean operation time was 41.9 ± 15.1 minutes. The success rates in the postoperative first and third mounts were 82.1% (55 renal units) and 88.0% (59 renal units), respectively. For 10 patients, second-session URS without fluoroscopy was needed. Clinically insignificant residual fragments were detected in three patients. There were no major complications.
URS without fluoroscopy for ureteral and renal stones in pediatric patients can be safely and effectively performed in experienced centers.
近年来，儿科人群的结石治疗有了显著改善。传统上，输尿管镜检查（URS）和/或逆行肾内手术是在荧光透视下进行的技术。使用荧光透视时，由于患者、医生和手术室工作人员受到辐射暴露，可能会出现包括恶性肿瘤在内的问题。本研究的目的是评估在输尿管和肾结石患儿中不使用荧光透视进行输尿管镜治疗的可能性。
2010年12月至2017年4月，儿科患者纳入本研究。对数据进行回顾性评估。URS由我们中心经验丰富的外科医生进行。手术期间不常规使用荧光透视。评估人口统计学数据、围手术期参数以及成功率和并发症发生率。
对61例患者的67个肾单位进行了手术。61例患者中有95.0%（67个肾单位中的95.5%）实现了无荧光透视的URS。3例患者在手术期间需要荧光透视。平均结石大小为12.4±5.3毫米，平均手术时间为41.9±15.1分钟。术后第一个月和第三个月的成功率分别为82.1%（55个肾单位）和88.0%（59个肾单位）。10例患者需要进行第二次无荧光透视的URS。3例患者检测到临床意义不显著的残留碎片。无重大并发症。
在经验丰富的中心，对儿科患者输尿管和肾结石进行无荧光透视的URS可以安全有效地进行。
