Zhan Ruichao, Ge Yucheng, Liu Yukun, Zhao Zhenqiang, Li Jun, Wang Wenying
Department of Urology, Beijing Friendship Hospital, Capital Medical University, 95 YongAn Road, Xicheng District, Beijing, 100050, China.
Urolithiasis. 2023 Apr 4;51(1):64. doi: 10.1007/s00240-023-01435-5.
The aim of this study is to evaluate the usefulness of microureteroscopy (m-URS) in the treatment of renal and ureteral stones in children younger than 3 years of age. A retrospective analysis of pediatric patients aged < 3 years with upper urinary tract calculi who underwent lithotripsy was performed. The children were divided into the m-URS group (4.85 F, n = 41) and the ureteroscopy (URS) group (4.5/6.5 F, n = 42) according to the type of ureteroscope used. The mean age of the patients was 23.5 ± 10.7 months in the m-URS group and 20.6 ± 7.1 months in the URS group (P = 0.212). The success rate of one-stage surgery was 80.5% (33/41) for m-URS and 38.1% (16/42) for URS (P < 0.001). The success rates of m-URS were 60.0%, 69.2%, and 91.3% for stones located in the renal pelvis/calix, upper ureter, and mid-lower ureter, respectively. Eight children in the m-URS group and 26 children in the URS group underwent the second-stage ureteroscopic surgery. The mean operation time was 50 (30-60) min in the m-URS group and 40 (34-60) min in the URS group (P = 0.287). The complication rates were 4.9% and 7.1% in the m-URS and URS groups, respectively (P = 1.000). The stone-free rate at 1 month after lithotripsy was 87.8% in the m-URS group and 83.3% in the URS group (P = 0.563). The mean anesthesia session was 2.1 in the m-URS group and 2.5 in the URS group (P = 0.002). M-URS can effectively reduce the number of anesthesia sessions and is considered an alternative treatment for upper urinary tract calculi in selected pediatric patients younger than 3 years of age.
本研究的目的是评估微通道输尿管镜检查（m-URS）在治疗3岁以下儿童肾及输尿管结石中的有效性。对年龄小于3岁的上尿路结石行碎石术的儿科患者进行回顾性分析。根据所使用的输尿管镜类型，将患儿分为m-URS组（4.85F，n = 41）和输尿管镜检查（URS）组（4.5/6.5F，n = 42）。m-URS组患者的平均年龄为23.5±10.7个月，URS组为20.6±7.1个月（P = 0.212）。m-URS一期手术成功率为80.5%（33/41），URS为38.1%（16/42）（P < 0.001）。位于肾盂/肾盏、上段输尿管和中下段输尿管的结石，m-URS的成功率分别为60.0%、69.2%和91.3%。m-URS组8例患儿和URS组26例患儿接受了二期输尿管镜手术。m-URS组平均手术时间为50（30 - 60）分钟，URS组为40（34 - 60）分钟（P = 0.287）。m-URS组和URS组的并发症发生率分别为4.9%和7.1%（P = 1.000）。碎石术后1个月的结石清除率，m-URS组为87.8%，URS组为83.3%（P = 0.563）。m-URS组平均麻醉次数为2.1次，URS组为2.5次（P = 0.002）。m-URS可有效减少麻醉次数，被认为是3岁以下特定儿科患者上尿路结石的一种替代治疗方法。
