Topaktas Ramazan, Aydin Cemil, Altin Selcuk, Akkoc Ali, Aydın Zeynep B, Urkmez Ahmet
Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, TUR.
Urology, Hitit University Erol Olcok Training and Research Hospital, Corum, TUR.
Cureus. 2019 Aug 27;11(8):e5496. doi: 10.7759/cureus.5496.
Introduction The aim of this study was to present our results regarding the feasibility and possible complications of 4.5 Fr semi-rigid ureterorenoscopy (URS) treatments in pediatric patients. Methods The files and computer records of a total of 33 pediatric patients (20 males and 13 females), who underwent URS procedures for ureteral stones > 5 mm between January 2013 and June 2017, were retrospectively reviewed. A 4.5 Fr semi-rigid ureteroscope (Ultrathin 4.5/6.5 Fr Ureterorenoscope; Richard Wolf GmbH, Knittlingen, Germany) was used for the URS procedures. For the stone-free rate evaluations, abdominopelvic ultrasound or direct radiography scans were performed one week after the surgery, and low-dose non-contrast computed tomography (CT) was performed during the first month. Results The mean age of the patients was 9.8 ± 2.8 (range 4-16) years old, and the mean ureteral stone size was 8.9 ± 1.4 (range 6-13) mm. The mean surgical duration was 45 ± 21.2 (range 30-75) minutes, and the mean hospital stay length was 1.2 (range 1-4) days. Minor complications occurred in five (15.1%) of the patients. The success rates for the first week and first month were 90.9% and 96.9%, respectively. Conclusion The endoscopic management of pediatric ureteral stones using a 4.5 Fr ureteroscope seems to be a safe and feasible treatment option with high success and low complication rates.
引言 本研究的目的是展示我们关于4.5 Fr半硬性输尿管肾镜检查（URS）治疗小儿患者的可行性及可能并发症的结果。方法 回顾性分析2013年1月至2017年6月期间共33例因输尿管结石>5 mm接受URS手术的小儿患者（20例男性和13例女性）的病历和计算机记录。使用4.5 Fr半硬性输尿管镜（超薄4.5/6.5 Fr输尿管肾镜；德国理查德·沃尔夫有限公司，克尼特林根）进行URS手术。为评估结石清除率，术后1周进行腹部盆腔超声或直接X线扫描，术后第1个月进行低剂量非增强计算机断层扫描（CT）。结果 患者的平均年龄为9.8±2.8（范围4 - 16）岁，输尿管结石平均大小为8.9±1.4（范围6 - 13）mm。平均手术时间为45±21.2（范围30 - 75）分钟，平均住院时间为1.2（范围1 - 4）天。五名（15.1%）患者出现轻微并发症。第1周和第1个月的成功率分别为90.9%和96.9%。结论 使用4.5 Fr输尿管镜对小儿输尿管结石进行内镜治疗似乎是一种安全可行的治疗选择，成功率高且并发症发生率低。
