Guanghua Peng, Jin Kuang, Yijian Chen, Xin Huang, Leming Song, Xiaolin Deng
{"title":"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。","authors":"Guanghua Peng, Jin Kuang, Yijian Chen, Xin Huang, Leming Song, Xiaolin Deng","doi":"10.1159/000539311","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Flexible ureteroscopy with a TFPC-UAS is safe and effective for renal stones in children.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Flexible ureteroscopy with a tip-flexible pressure-controlling ureteral access sheath for renal stones in children.\",\"authors\":\"Guanghua Peng, Jin Kuang, Yijian Chen, Xin Huang, Leming Song, Xiaolin Deng\",\"doi\":\"10.1159/000539311\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Flexible ureteroscopy with a TFPC-UAS is safe and effective for renal stones in children.</p>\",\"PeriodicalId\":23414,\"journal\":{\"name\":\"Urologia Internationalis\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urologia Internationalis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000539311\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Internationalis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000539311","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Flexible ureteroscopy with a tip-flexible pressure-controlling ureteral access sheath for renal stones in children.
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.
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.
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