Garzi A, Prestipino M, Calabrò E, Di Crescenzo R M, Rubino M S
Division of Pediatric M.I.S. and Robotic Surgery University of Salerno, Italy.
Division of Pediatric Surgery A.O. S. Maria della Misericordia Perugia, Italy.
Transl Med UniSa. 2020 May 31;22:46-49. eCollection 2020 May.
Urolithiasis is a multifactorial disease; in recent years, its incidence has gradually increased in pediatric age. Among the factors involved in urolithiasis pathophysiology, urinary tract anomalies and metabolic diseases are the most relevant, although ethnicity and environmental factors may have an important role. The advances in technology and miniaturization of endoscopic devices have permitted the use of Retrograde Intrarenal Surgery (RIRS) to treat kidney and ureteral stones. Nowadays, flexible ureterorenoscopy and laser lithotripsy, which are techniques that have been applied in the management of adult upper urinary tract disorders, are also used in children as a minimally invasive treatment of urolithiasis with encouraging, effective and safe results. The Authors report a retrospective review of their record of cases considering 21 pediatric urolithiasis treatment procedures performed between October 2017 and April 2019 in a total of 17 patients (10 males and 7 females). Six procedures involved the use of the flexible ureterorenoscope (FURS) while in 15 procedures the application of the laser fiber was used (FURSL). A case of laser lithotripsy for bladder stone was included. The average age of patients was 10.5 years (2-18 years). The renal pelvis dilatation pretreatment was evaluated in post-operative follow-up. From the evaluation of the sample in analysis, the use of RIRS has good results in the treatment of paediatric urolithiasis, emerging as a valid option in the management of the paediatric population in terms of efficacy and safety, with an improvement in patient outcomes.
尿石症是一种多因素疾病；近年来，其发病率在儿童期逐渐上升。在尿石症病理生理学涉及的因素中，尿路异常和代谢疾病最为相关，尽管种族和环境因素可能也起重要作用。技术的进步和内镜设备的小型化使得逆行性肾内手术（RIRS）可用于治疗肾结石和输尿管结石。如今，已应用于成人上尿路疾病管理的软性输尿管肾镜检查和激光碎石术，也作为尿石症的微创治疗方法用于儿童，取得了令人鼓舞的、有效且安全的结果。作者报告了一项对其病例记录的回顾性研究，该研究纳入了2017年10月至2019年4月期间对总共17例患者（10例男性和7例女性）实施的21例儿童尿石症治疗手术。其中6例手术使用了软性输尿管肾镜（FURS），15例手术应用了激光光纤（FURSL）。还纳入了1例膀胱结石激光碎石术病例。患者的平均年龄为10.5岁（2至18岁）。在术后随访中评估肾盂扩张的预处理情况。通过对分析样本的评估，RIRS在儿童尿石症治疗中取得了良好效果，在疗效和安全性方面成为儿童患者管理中的一个有效选择，改善了患者的治疗结果。
