Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
J Pediatr Urol. 2024 Jun;20(3):395-399. doi: 10.1016/j.jpurol.2023.12.003. Epub 2023 Dec 12.
Pediatric urolithiasis is a less common disease with a steadily increasing incidence of 10.6 % per year. The comprehensive management of pediatric urolithiasis is more challenging than in adults, and published studies of endourological treatment in children have small sample sizes and older mean ages, which may not be representative of the overall pediatric population, especially in infants and toddlers. This study aimed to report results of retrograde ureteroscopy for treating pediatric ureteral stones in infants and toddlers (<3 years) from a single center in China.
Demographic and surgical data of infants and toddlers with ureteral stones who underwent retrograde URS were retrospectively analyzed from January 2015 to September 2022.
The mean age of 100 infants (73 boys and 27 girls) was 19.6 ± 7.6 months and stone burden was 0.27 (0.11-0.52) cm³. 111 procedures were performed for all children due to 11 patients with bilateral ureteric stones were simultaneously treated. Among them, 70.3 % were semi-rigid URS, 12.6 % were Micro-URS and 17.1 % were flexible URS. SFR was up to 96 %, the median operation time and hospitalization days were 35.0 (25.0-50.0) minutes and 6.0 (5.0-6.0) days, respectively. 15 (15.0 %) infants had postoperative fever (Grade I), and complications above grade I were not observed.
This research reported the largest sample size of infant and toddler ureteric stones (under 3 years old) and shared optimal management strategies for these special populations. Compared to other related studies, we had a higher SFR due to diverse management strategies and reasonable application of pre-operative ureteric stents. The most important potential reason why our complication rate was relatively higher might be the younger population under 3 years old. In additionally, the reason of long hospitalization was maybe some patients underwent staged surgeries during one hospitalization. Those results indicated the robust effectiveness of URS for infants. This study has limitations, including its retrospective single-center design, absence of long-term follow-up data, and potential variability in surgical outcomes due to differences in surgeons' experience.
The experience of endourologic procedures for 100 infant and toddler patients with ureteric stones from a Chinese single center was reported. And URS showed its effectiveness and safety for those special populations based on its high SFR and low complication rate.
小儿尿石症是一种较少见的疾病，其发病率以每年 10.6%的速度稳步上升。小儿尿石症的综合管理比成人更具挑战性，而且发表的关于儿童腔内治疗的研究样本量小，平均年龄较大，可能无法代表整个儿科人群，尤其是婴儿和幼儿。本研究旨在报告中国单中心应用逆行输尿管镜治疗婴儿和幼儿（<3 岁）输尿管结石的结果。
回顾性分析 2015 年 1 月至 2022 年 9 月期间接受逆行输尿管镜治疗的 100 例婴儿（73 例男性，27 例女性）输尿管结石患儿的人口统计学和手术资料。
100 例婴儿的平均年龄为 19.6±7.6 个月，结石负荷为 0.27（0.11-0.52）cm³。11 例双侧输尿管结石患儿同时进行了 111 次治疗。其中，70.3%为半刚性输尿管镜，12.6%为微输尿管镜，17.1%为软性输尿管镜。SFR 高达 96%，中位手术时间和住院天数分别为 35.0（25.0-50.0）分钟和 6.0（5.0-6.0）天。15 例（15.0%）婴儿术后发热（Ⅰ级），无Ⅰ级以上并发症。
本研究报告了最大的婴儿和幼儿输尿管结石样本量（<3 岁），并分享了针对这些特殊人群的最佳管理策略。与其他相关研究相比，由于管理策略的多样性和术前输尿管支架的合理应用，我们的 SFR 更高。并发症发生率相对较高的一个潜在原因可能是我们的研究人群年龄更小，都在 3 岁以下。另外，住院时间长的原因可能是部分患者在一次住院期间进行了分期手术。这些结果表明 URS 对婴儿的有效性。本研究存在一些局限性，包括回顾性单中心设计、缺乏长期随访数据以及由于外科医生经验的差异导致手术结果的潜在变异性。
本研究报道了中国单中心 100 例婴儿和幼儿输尿管结石患者的腔内治疗经验。基于高 SFR 和低并发症率，URS 对这些特殊人群显示出了有效性和安全性。
