Flexible ureteroscopy with a tip-flexible pressure-controlling ureteral access sheath for renal stones in children.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2024-05-16 DOI:10.1159/000539311

Guanghua Peng, Jin Kuang, Yijian Chen, Xin Huang, Leming Song, Xiaolin Deng

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Abstract

Background: 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.

Methods: 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 mmHg to 5 mmHg, warning value at 20 mmHg, and limit value at 30 mmHg. 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.

Results: 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 mmHg. 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 two 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.

Conclusions: Flexible ureteroscopy with a TFPC-UAS is safe and effective for renal stones in children.

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使用尖端灵活的压力控制输尿管通路鞘管进行输尿管软镜检查，治疗儿童肾结石。

背景：评估使用尖端柔性压力控制输尿管入路鞘（TFPC-UAS）进行输尿管软镜检查治疗儿童肾结石的安全性和有效性：目的：评估使用尖端柔性压力控制输尿管通路鞘（TFPC-UAS）的柔性输尿管镜检查治疗儿童肾结石的安全性和有效性：方法： 2022年1月至2023年11月期间，赣州市人民医院连续收治了5-18岁肾结石患者，结石直径为1-3厘米。采用 TFPC-UAS 对患者进行输尿管软镜治疗。肾盂压力（RPP）参数设置如下：控制值为 -10 mmHg 至 5 mmHg，警戒值为 20 mmHg，极限值为 30 mmHg。输液流速设定为 100-120 毫升/分钟。使用钬激光（276 μm）以 2.0-2.5 J/脉冲、20-30 脉冲/秒的频率击碎结石。对病例的RPP、手术时间、无石率和并发症进行了分析：结果：共纳入 21 例连续患者。结果：共纳入 21 例连续患者，其中 2 例患者因鞘瘤置入失败而改用经皮肾镜碎石术。RPP为-4.6±2.1 mmHg。平均手术时间为（56.5±17.1）分钟。术后住院时间为（1.5±0.3）天。术后1天和1个月的无结石率分别为81.0%和85.7%。两名患者的残余结石在体外冲击波碎石后被清除。出现了三例克拉维恩Ⅰ型并发症和一例克拉维恩Ⅱ型并发症。没有观察到重大并发症（Clavien III-V级）：结论：使用TFPC-UAS进行输尿管软镜检查治疗儿童肾结石安全有效。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.