Department of Urology, Ganzhou People's Hospital, Ganzhou, China.
Department of Anesthesia, Ganzhou People's Hospital, Ganzhou, China.
Urol Int. 2024;108(5):429-433. doi: 10.1159/000539311. Epub 2024 May 16.
The aim of this study was to evaluate the safety and efficacy of flexible ureteroscopy using a tip-flexible pressure-controlling ureteral access sheath (TFPC-UAS) for renal stones in children.
Consecutive patients aged 5-18 years with renal stones of diameter 1-3 cm were enrolled between January 2022 and November 2023 at Ganzhou People's Hospital. The patients were treated with flexible ureteroscopy using the TFPC-UAS. The renal pelvic pressure (RPP) parameters were set as follows: control value at -10 mm Hg to 5 mm Hg, warning value at 20 mm Hg, and limit value at 30 mm Hg. The infusion flow rate was set to 100-120 mL/min. A holmium laser (276 μm) was used to fragment the stone at 2.0-2.5 J/pulse with a frequency of 20-30 pulses/s. The cases were analyzed for RPP, operative time, stone-free rate, and complications.
A total of 21 consecutive patients were included. Two patients were switched to percutaneous nephrolithotomy owing to sheath placement failure. The RPP was -4.6 ± 2.1 mm Hg. The mean operative time was 56.5 ± 17.1 min. The postoperative hospitalization time was 1.5 ± 0.3 days. The stone-free rates at 1 day and 1 month after surgery were 81.0% and 85.7%, respectively. Residual stones in 2 patients were cleared after extracorporeal shockwave lithotripsy. Three cases of Clavien I complications and one case of Clavien II complications occurred. No major complications (Clavien grade III-V) were observed.
Flexible ureteroscopy with a TFPC-UAS is safe and effective for renal stones in children.
本研究旨在评估使用尖端可弯曲压力控制输尿管鞘（TFPC-UAS）进行儿童肾结石的软性输尿管镜检查的安全性和疗效。
2022 年 1 月至 2023 年 11 月，我院连续纳入直径为 1-3cm 的肾结石 5-18 岁患儿。采用 TFPC-UAS 进行软性输尿管镜检查。肾盂压力（RPP）参数设置如下：控制值为-10mmHg 至 5mmHg，警告值为 20mmHg，限制值为 30mmHg。灌注流速设定为 100-120mL/min。采用 276μm 钬激光以 2.0-2.5J/脉冲、20-30 脉冲/s 的频率碎石。分析 RPP、手术时间、结石清除率和并发症。
共纳入 21 例连续患者。2 例因鞘管放置失败转为经皮肾镜碎石术。RPP 为-4.6±2.1mmHg。平均手术时间为 56.5±17.1min。术后住院时间为 1.5±0.3 天。术后 1 天和 1 个月的结石清除率分别为 81.0%和 85.7%。2 例患者术后残石经体外冲击波碎石清除。3 例发生 Clavien I 级并发症，1 例发生 Clavien II 级并发症。无严重并发症（Clavien 分级 III-V 级）发生。
使用 TFPC-UAS 的软性输尿管镜检查治疗儿童肾结石是安全有效的。
