Jahrreiss Victoria, Madarriaga Yesica Quiroz, Tur Anna Bujons, de Knecht Erika Llorens, Griffin Stephen, Somani Bhaskar
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom.
Cent European J Urol. 2024;77(1):37-41. doi: 10.5173/ceju.2023.248. Epub 2024 Jan 20.
Although pediatric urolithiasis remains relatively uncommon, its global prevalence is on the rise. Technological advances have led to miniaturization of instruments especially in the form of single use scopes. As the evidence on the use of small single use ureteroscopes in children is scarce, we have conducted a pilot two-center study to analyze the outcomes of pediatric patients treated with the Pusen 7.5 Fr single use scopes at our institutions.
This study included consecutive pediatric patients with urinary stones treated with the small Pusen 7.5 Fr single use ureteroscope. The study was conducted at two large European tertiary endourology centers that specialize in pediatric kidney stone management. Patient data and outcomes were prospectively collected, and analysis was performed regarding patient demographics, stone parameters, as well as stone free rate (SFR), operating time, and complications.
In this pilot study, 26 patients were included with a median age of 12 years (7.0-16.0) and a male to female ratio of 14:12. The mean cumulative stone size was 15.15 mm (SD ±11.1) and multiple stones were present in 9 (34.6%) patients. Pre-operative stent, access sheath and post-operative stent usage was done in 12 (46.2%), 23 (88.5%) and 13 (50%) patients respectively. The median operative time was 47 minutes (IQR: 40.0-63.8). Following the initial procedure 24 (92.3%) patients were stone free, while no intra or postoperative complications were observed.
Our study demonstrates that the use of the small 7.5 single use ureteroscope is safe and efficient for the treatment of urinary stones in pediatric patients with high stone-free rates and no complications noted in our series. While this might become a standard of care in future, to confirm and validate our findings further studies with larger cohorts are warranted.
尽管小儿尿石症仍然相对不常见，但其全球患病率正在上升。技术进步导致器械小型化，尤其是一次性输尿管镜形式。由于关于在儿童中使用小型一次性输尿管镜的证据稀少，我们进行了一项双中心试点研究，以分析在我们机构中使用普森7.5 Fr一次性输尿管镜治疗的儿科患者的治疗结果。
本研究纳入了连续使用小型普森7.5 Fr一次性输尿管镜治疗尿路结石的儿科患者。该研究在两个大型欧洲三级腔内泌尿外科中心进行，这些中心专门从事小儿肾结石管理。前瞻性收集患者数据和结果，并对患者人口统计学、结石参数以及无石率（SFR）、手术时间和并发症进行分析。
在这项试点研究中，纳入了26例患者，中位年龄为12岁（7.0 - 16.0岁），男女比例为14:12。平均累积结石大小为15.15 mm（标准差±11.1），9例（34.6%）患者存在多发结石。分别有12例（46.2%）、23例（88.5%）和13例（50%）患者使用了术前支架、通道鞘和术后支架。中位手术时间为47分钟（四分位间距：40.0 - 63.8）。初次手术后，24例（92.3%）患者无结石残留，且未观察到术中或术后并发症。
我们的研究表明，使用小型7.5 Fr一次性输尿管镜治疗小儿尿路结石是安全有效的，无石率高，且我们的系列研究中未发现并发症。虽然这可能会在未来成为一种标准治疗方法，但为了证实和验证我们的发现，有必要进行更大样本量的进一步研究。
