{"title":"内窥镜肾结石和输尿管结石手术对儿童肾血流量的影响：一项前瞻性试验。","authors":"Fevzi Batuhan Topbas, Cagri Akin Sekerci, Efe Soydemir, Ozge Yapici, Serkan Akbas, Selcuk Yucel, Tufan Tarcan, Yiloren Tanidir","doi":"10.1007/s00240-024-01578-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children.</p><p><strong>Materials and methods: </strong>Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys.</p><p><strong>Results: </strong>A total of 45 children with a median age was 8 (2-17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period.</p><p><strong>Conclusion: </strong>RDUS parameters didn't show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"84"},"PeriodicalIF":2.0000,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161530/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effect of endoscopic renal and ureteral stone surgeries on renal blood flow in children: a prospective trial.\",\"authors\":\"Fevzi Batuhan Topbas, Cagri Akin Sekerci, Efe Soydemir, Ozge Yapici, Serkan Akbas, Selcuk Yucel, Tufan Tarcan, Yiloren Tanidir\",\"doi\":\"10.1007/s00240-024-01578-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children.</p><p><strong>Materials and methods: </strong>Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys.</p><p><strong>Results: </strong>A total of 45 children with a median age was 8 (2-17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period.</p><p><strong>Conclusion: </strong>RDUS parameters didn't show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease.</p>\",\"PeriodicalId\":23411,\"journal\":{\"name\":\"Urolithiasis\",\"volume\":\"52 1\",\"pages\":\"84\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-06-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161530/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urolithiasis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00240-024-01578-z\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urolithiasis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00240-024-01578-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估内镜结石手术对儿童肾脏灌注和血流的影响：研究对象包括接受经皮肾镜取石术（PCNL）、逆行肾内手术（RIRS）、输尿管造影术（URS）和内镜联合肾内手术（ECIRS）的儿童。在手术前一天、术后第一天和一个月进行肾脏多普勒超声检查（RDUS）。测量峰值收缩速度（PSV）和舒张末速度（EDV），并用（PSV-EDV）/PSV公式计算阻力指数（RI）。比较手术前后以及同侧和对侧肾脏的 RDUS 参数：共纳入 45 名儿童，中位年龄为 8（2-17）岁（15 名女孩（33.3%），30 名男孩（66.7%））。13名儿童（28.9%）接受了PCNL手术，11名儿童（24.4%）接受了RIRS手术，12名儿童（26.7%）接受了URS手术，9名儿童（20%）接受了ECIRS手术。术前和术后，手术肾脏的肾脏和节段 PSV、EDV 和 RI 值无明显差异。同侧肾脏和对侧肾脏的 RDUS 参数在术前、术后均无明显差异。术前未植入 DJ 支架组的 PSV 和 EDV 值在术后第一个月明显高于植入 DJ 支架组（分别为 p = 0,031 和 p = 0,041）。但 RI 值相似。结论：结论：RDUS参数在儿童中没有明显差异。结论：RDUS参数在儿童中未显示出明显差异，内镜手术可安全地用于小儿结石病。
The effect of endoscopic renal and ureteral stone surgeries on renal blood flow in children: a prospective trial.
Aim: To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children.
Materials and methods: Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys.
Results: A total of 45 children with a median age was 8 (2-17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period.
Conclusion: RDUS parameters didn't show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease.
期刊介绍：
Official Journal of the International Urolithiasis Society
The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field.
Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.
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