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小儿肾及输尿管结石的微创手术:治疗进展

Minimally invasive surgery for pediatric renal and ureteric stones: A therapeutic update.

作者信息

Peng Tao, Zhong Hongcai, Hu Baohui, Zhao Shankun

机构信息

Department of Pediatric Surgery, Huizhou Central People's Hospital, Huizhou, China.

Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.

出版信息

Front Pediatr. 2022 Aug 18;10:902573. doi: 10.3389/fped.2022.902573. eCollection 2022.

Abstract

The incidence of pediatric urolithiasis (PU) is growing worldwide. The corresponding therapeutic methods have become a research hot spot in pediatric urology. PU has the characteristics of abnormal metabolism, easy recurrence, and immature urinary system development, which make its treatment different from that of adults. Pediatric urologists should select the optimal treatment modality to completely remove the stones to prevent recurrence. Currently, the curative treatments of PU include extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, retrograde intrarenal surgery, percutaneous nephrolithotomy (PCNL), laparoscopic, robot-assisted laparoscopic, and open surgery. This review aims to conduct a therapeutic update on the surgical interventions of both pediatric renal and ureteric stones. It accentuates that pediatric surgeons or urologists should bear in mind the pros and cons of various minimally invasive surgical treatments under different conditions. In the future, the treatment of PU will be more refined due to the advancement of technology and the development of surgical instruments. However, a comprehensive understanding of the affected factors should be taken into account by pediatric urologists to select the most beneficial treatment plan for individual children to achieve precise treatment.

摘要

小儿尿路结石(PU)的发病率在全球范围内呈上升趋势。相应的治疗方法已成为小儿泌尿外科的研究热点。PU具有代谢异常、易复发以及泌尿系统发育不成熟的特点,这使得其治疗与成人不同。小儿泌尿外科医生应选择最佳治疗方式以完全清除结石,防止复发。目前,PU的治疗方法包括体外冲击波碎石术(ESWL)、输尿管镜检查、逆行肾内手术、经皮肾镜取石术(PCNL)、腹腔镜手术、机器人辅助腹腔镜手术和开放手术。本综述旨在对小儿肾结石和输尿管结石的手术干预进行治疗更新。强调小儿外科医生或泌尿外科医生应牢记不同情况下各种微创手术治疗的利弊。未来,由于技术进步和手术器械的发展,PU的治疗将更加精细化。然而,小儿泌尿外科医生应综合考虑影响因素,为每个患儿选择最有益的治疗方案,以实现精准治疗。

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