Gholdoian C G, Thayer K, Hald D, Rajpoot D, Shanberg A M
Division of Urology, University of California, Irvine College of Medicine-UCI Medical Center, Orange, USA.
J Clin Laser Med Surg. 1998 Feb;16(1):39-43. doi: 10.1089/clm.1998.16.39.
We describes our experience using the potassium titanyl phosphate (KTP)-532 laser in treating posterior urethral valves, ureteroceles, and urethral strictures in the pediatric patient.
A retrospective chart review was performed from 1987 to 1997 on a total of 33 pediatric patients who underwent retrograde endoscopic treatment for posterior urethral valves (PUV), ureteroceles (UC), and urethral strictures using a KTP-532 laser.
Overall, our success rate was excellent in the treatment of valves and ureteroceles. With a mean follow-up of three years in the PUV group, no urethral strictures of micturation abnormalities were seen. The majority of ureteroceles were decompressed and only half of our patients required and additional procedure. Our experience with urethral strictures, however, was not as promising. All of these patients ultimately required open urethral reconstruction.
The desirable thermal characteristics of the KTP laser, along with minimal complications and the availability of delicate pediatric endoscopic instruments have made this operation optimally suited for treating posterior urethral valves and ureteroceles in infants. However, the advantages for treating urethral strictures in children with the laser still remains to be established.
我们描述了使用磷酸钛氧钾(KTP)-532激光治疗小儿患者后尿道瓣膜、输尿管囊肿和尿道狭窄的经验。
对1987年至1997年间共33例接受逆行内镜治疗后尿道瓣膜(PUV)、输尿管囊肿(UC)和尿道狭窄的小儿患者进行回顾性病历审查,治疗采用KTP-532激光。
总体而言,我们在瓣膜和输尿管囊肿的治疗方面成功率很高。在PUV组平均三年的随访中,未发现排尿异常的尿道狭窄。大多数输尿管囊肿得到减压,只有一半的患者需要额外的手术。然而,我们在尿道狭窄方面的经验并不那么乐观。所有这些患者最终都需要进行开放性尿道重建。
KTP激光理想的热特性,加上并发症极少以及有精细的小儿内镜器械,使得该手术非常适合治疗婴儿的后尿道瓣膜和输尿管囊肿。然而,激光治疗儿童尿道狭窄的优势仍有待确立。