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儿童多发泌尿系畸形和孤立性双肾盂畸形行微创经皮肾镜取石术。

Mini-percutaneous nephrolithotomy in a child with multiple urogenital anomalies and a solitary duplex kidney.

机构信息

Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.

出版信息

Int Braz J Urol. 2021 Mar-Apr;47(2):464-467. doi: 10.1590/S1677-5538.IBJU.2019.0545.

Abstract

PURPOSE

: To report a case of successful removal of right staghorn renal calculi in a 3-year-old girl with Arnold-Chiari malformation and multiple urogenital anomalies.

CASE REPORT

: A 3-year-old female child with the diagnosis of Arnold-Chiari type 2 malformation was referred to our clinic due to presence of 9 kidney stones with a total volume of 10743mm3. The total of the longest diameters of all stones was calculated as 11.4cm. The patient had a urogenital septum, bifid bladder, and duplicated collecting system on the right side. An 18F Amplatz sheath was placed and mini-percutaneous nephrolithotomy was performed successfully by laser and pneumatic lithotripter. Any residual urinary tract stones or urinary tract infection were not detected during the 6th-month follow-up.

CONCLUSION

: Urolithiasis requires a thorough understanding of the underlying causes, as well as an effective and minimally invasive treatment. It is important for urologists to understand the complexity of the optimal stone management in pediatric patients in order to maximize treatment efficacy and minimize morbidity. We conclude that it is essential to treat urolithiasis in a single session in children with urogenital anomalies and accompanying congenital anomalies who have past surgical history.

摘要

目的

报告 1 例成功为患有 Arnold-Chiari 畸形和多种泌尿生殖系统异常的 3 岁女孩取出右侧鹿角状肾结石的病例。

病例报告

1 名 3 岁女性患儿被诊断为 Arnold-Chiari 2 型畸形,因存在 9 颗肾结石(结石总容积为 10743mm3)而被转至我科。所有结石最长直径的总和为 11.4cm。该患者存在尿生殖隔、双份膀胱和右侧重复收集系统。放置 18F Amplatz 鞘后,成功地使用激光和气压弹道碎石器进行了微创经皮肾镜碎石术。在第 6 个月的随访中,未发现任何残余尿路结石或尿路感染。

结论

结石病需要深入了解其根本原因,并进行有效且微创的治疗。泌尿外科医生需要了解儿科患者最佳结石管理的复杂性,以便最大限度地提高治疗效果并降低发病率。我们的结论是,对于有既往手术史的存在泌尿生殖系统异常和伴随先天性异常的儿童,有必要在单次就诊中治疗结石病。

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本文引用的文献

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Evaluation and medical management of kidney stones in children.儿童肾结石的评估与药物治疗
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