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使用一次性软性输尿管镜和高功率激光设置成功治疗一名2岁男孩的多发性大型肾内结石

Successful Treatment of Multiple Large Intrarenal Stones in a 2-Year-Old Boy Using a Single-Use Flexible Ureteroscope and High-Power Laser Settings.

作者信息

Tatanis Vasileios, Spinos Theodoros, Lamprinou Zoi, Kanna Elisavet, Mulita Francesk, Peteinaris Angelis, Achilleos Orthodoxos, Skondras Ioannis, Liatsikos Evangelos, Kallidonis Panagiotis

机构信息

Department of Urology, University of Patras Hospital, 26504 Patras, Greece.

2nd Department of Pediatric Surgery, P & A Kyriakou Children's Hospital, 11527 Athens, Greece.

出版信息

Pediatr Rep. 2024 Sep 11;16(3):806-815. doi: 10.3390/pediatric16030068.

Abstract

The standard treatment procedures for managing renal calculi in the pediatric population are similar to those in adults. The application of flexible ureteroscopy has contributed to the increased popularity of retrograde intrarenal surgery (RIRS) as an alternative therapeutic modality that can be successfully applied in children. One of the most significant innovations of the last decade is the introduction of single-use flexible ureteroscopes (fURSs). In this case report, we present the case of a 2-year-old boy with multiple large calculi in his right kidney, which were successfully removed after a single session of RIRS using a 7.5 F single-use fURS and high-power laser settings. The total operative and lithotripsy times were estimated at 90 and 75 min, respectively. No complications were recorded. The hemoglobin loss was calculated at 0.3 mg/dL, while the creatinine level was decreased by 0.1 mg/dL. The urethral catheter was removed on the first postoperative day, and the patient was discharged. The management of multiple or large kidney stones is very challenging in the pediatric population under the age of three years. Convenient preoperative planning and the appropriate use of available equipment may lead to excellent outcomes accompanied by a reduced risk for complications.

摘要

儿科人群肾结石的标准治疗程序与成人相似。可弯曲输尿管镜的应用促使逆行性肾内手术(RIRS)作为一种可成功应用于儿童的替代治疗方式越来越受欢迎。过去十年最重要的创新之一是一次性可弯曲输尿管镜(fURSs)的引入。在本病例报告中,我们介绍了一名2岁男孩的病例,其右肾有多个大结石,使用7.5F一次性fURS和高功率激光设置,在单次RIRS手术后成功取出结石。估计总手术时间和碎石时间分别为90分钟和75分钟。未记录到并发症。血红蛋白损失计算为0.3mg/dL,而肌酐水平下降了0.1mg/dL。术后第一天拔除尿道导管,患者出院。对于三岁以下的儿科人群,处理多个或大的肾结石极具挑战性。便捷的术前规划和适当使用现有设备可能带来良好的结果,同时降低并发症风险。

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