Xiao Jing, Wang Xiangyu, Li Jun, Wang Miaoiao, Han Tiandong, Zhang Caixiang, Du Yuan, Hao Gangyue, Tian Ye
Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Can Urol Assoc J. 2019 Mar;13(3):E78-E82. doi: 10.5489/cuaj.5283. Epub 2018 Aug 30.
This single-centre, retrospective study aimed to assess the efficacy and safety of flexible ureteroscopy (FURS) combined with holmium laser lithotripsy in treating children with upper urinary tract stones.
From June 2014 to October 2015, a total of 100 children (74 boys and 26 girls) with upper urinary tract stones were treated using FURS. A 4.7 Fr double-J stent was placed two weeks before operation. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. The preoperative, operative, and postoperative data of the patients were retrospectively analyzed.
A total of 100 pediatric patients with a mean age of 3.51±1.82 years underwent 131 FURS and holmium laser lithotripsy. Mean stone diameter was 1.49±0.92 cm. Average operation time was 30.8 minutes (range 15-60). The laser power was controlled between 18 and 32 W, and the energy maintained between 0.6 and 0.8 J at any time; laser frequency was controlled between 30 and 40 Hz. Complications were observed in 69 (69.0 %) patients and classified according to the Clavien system. Postoperative hematuria (Clavien I) occurred in 64 (64.0 %) patients. Postoperative urinary tract infection with fever (Clavien II) was observed in 8/113 (7.1%) patients. No ureteral perforation and mucosa avulsion occurred. The overall stone-free rate of single operation was 89/100 (89%). Stone diameter and staghorn calculi were significantly associated with stone-free rate.
FURS and holmium laser lithotripsy is effective and safe in treating children with upper urinary tract stones.
本单中心回顾性研究旨在评估输尿管软镜（FURS）联合钬激光碎石术治疗儿童上尿路结石的有效性和安全性。
2014年6月至2015年10月，共100例上尿路结石患儿（74例男孩，26例女孩）接受了FURS治疗。术前两周放置4.7 Fr双J管。当影像学检查未发现残留结石碎片时，患者被视为结石清除。对患者的术前、术中及术后数据进行回顾性分析。
100例平均年龄为3.51±1.82岁的儿科患者接受了131次FURS联合钬激光碎石术。平均结石直径为1.49±0.92 cm。平均手术时间为30.8分钟（范围15 - 60分钟）。激光功率控制在18至32 W之间，能量随时保持在0.6至0.8 J之间；激光频率控制在30至40 Hz之间。69例（69.0%）患者出现并发症，并根据Clavien系统进行分类。64例（64.0%）患者出现术后血尿（Clavien I级）。8/113例（7.1%）患者出现术后发热性尿路感染（Clavien II级）。未发生输尿管穿孔和黏膜撕脱。单次手术的总体结石清除率为89/100（89%）。结石直径和鹿角形结石与结石清除率显著相关。
FURS联合钬激光碎石术治疗儿童上尿路结石有效且安全。
