Shroff S, Watson G M
Institute of Urology and Nephrology, London, UK.
Br J Urol. 1995 Mar;75(3):395-400. doi: 10.1111/j.1464-410x.1995.tb07356.x.
To present our experience of ureteroscopic procedures in children using miniaturized instrumentation.
Fourteen children aged between 13 months and 14 years underwent 20 ureteroscopic procedures. Semi-rigid 7.2 F and flexible 9.5 F ureteroscopes were used in a retrograde and an antegrade fashion. Eighteen ureteroscopies were performed retrogradely and two antegradely. Of the 20 ureteroscopic procedures, 18 were for stone disease, one for haematuria of unknown origin and one for removal of a migrated stent. The average size of the stone was 12.9 x 6.6 mm.
Access using miniaturized ureteroscopes was successful in all patients. Dilatation was required only in 1 of 20 procedures. The management of stone disease in 10 of 13 children was straightforward and a single ureteroscopy was required to clear the ureters. In three of 13 children with stone disease the problems were more complex and nine ureteroscopies were undertaken to render the ureters stone free. Complications were stricture at the site of stone impaction (one patient), retention of urine due to a stone fragment in the urethra (one patient), haematuria (one patient) and migrated stent requiring ureteroscopy (one patient).
In the hands of an experienced surgeon ureteroscopy can be used with equal success in children as in adults to treat calculus disease.
介绍我们使用小型器械进行儿童输尿管镜手术的经验。
14名年龄在13个月至14岁之间的儿童接受了20次输尿管镜手术。使用半硬性7.2F和软性9.5F输尿管镜进行逆行和顺行操作。18次输尿管镜检查为逆行操作，2次为顺行操作。在这20次输尿管镜手术中，18次用于治疗结石病，1次用于不明原因的血尿，1次用于取出移位的支架。结石的平均大小为12.9×6.6毫米。
所有患者使用小型输尿管镜均成功进入。20例手术中仅1例需要扩张。13名儿童中有10名的结石病处理简单，单次输尿管镜检查即可清除输尿管结石。13名结石病儿童中有3名情况较为复杂，进行了9次输尿管镜检查以清除输尿管结石。并发症包括结石嵌顿部位狭窄（1例患者）、尿道结石碎片导致尿潴留（1例患者）、血尿（1例患者）以及移位支架需要输尿管镜检查（1例患者）。
在经验丰富的外科医生手中，输尿管镜在儿童中治疗结石病与在成人中一样成功。
