Sinha Mriganka, Pietropaolo Amelia, Quiroz Madarriaga Yesica, de Knecht Erika Llorens, Bujons Tur Anna, Griffin Stephen, Somani Bhaskar K
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Urology Department, Fundació Puigvert, Barcelona, Spain.
Ther Adv Urol. 2022 Dec 20;14:17562872221141775. doi: 10.1177/17562872221141775. eCollection 2022 Jan-Dec.
Although paediatric ureteroscopy is widely performed, there is still a lack of data and outcomes in early childhood. In this two-centre study, we compared the outcomes of ureteroscopy for stone disease management in early and late childhood and provide outcomes for the same.
Data was retrospectively collected on consecutive patients from two tertiary paediatric endo-urology European centres over a 15-year period (2006-2021). Patients were split into two groups, namely, early childhood (age ⩽ 9 years) and late childhood (age 9 to ⩽16 years). Outcomes including stone-free rate (SFR) and complications were compared between these two groups.
A total of 148 patients underwent 184 procedures (1.2 procedure/patient) during the study period (66 in early childhood and 82 in late childhood). The mean age in early and late childhood groups were 5.6 and 13.3 years, and a male: female ratio of 1.6:1 and 1.1:1, respectively. The SFR and complications in early and late childhood groups were 87.8% and 90.2% ( = 0.64) and 5.7% and 4.1%, respectively.
Paediatric ureteroscopy and laser stone fragmentation achieves good results in both early and late childhood with comparable SFRs, although the complications and need for second procedure were marginally higher in the early childhood group. Our study would set up a new benchmark for patient counselling in future, and perhaps this needs to be reflected in the paediatric urolithiasis guidelines.
尽管小儿输尿管镜检查已广泛开展，但幼儿期的数据和结果仍然缺乏。在这项双中心研究中，我们比较了幼儿期和儿童晚期输尿管镜治疗结石疾病的结果，并提供了相应结果。
回顾性收集了欧洲两家三级小儿泌尿内镜中心15年期间（2006 - 2021年）连续患者的数据。患者分为两组，即幼儿期（年龄≤9岁）和儿童晚期（年龄9至≤16岁）。比较两组的无结石率（SFR）和并发症等结果。
在研究期间，共有148例患者接受了184次手术（1.2次手术/患者）（幼儿期66例，儿童晚期82例）。幼儿期和儿童晚期组的平均年龄分别为5.6岁和13.3岁，男女比例分别为1.6:1和1.1:1。幼儿期和儿童晚期组的无结石率分别为87.8%和90.2%（P = 0.64），并发症发生率分别为5.7%和4.1%。
小儿输尿管镜检查和激光碎石术在幼儿期和儿童晚期均取得了良好效果，无结石率相当，尽管幼儿期组的并发症和二次手术需求略高。我们的研究将为未来患者咨询建立一个新的基准，也许这需要在小儿尿路结石指南中得到体现。
