Use of the holmium:YAG laser for ureterolithotripsy in children
| Autor: | Bulent Akdogan, Mehmet Selcuk Keskin, Serdar Tekgul, Hasan Serkan Dogan, Ahmet Z. Sahin |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Ureteral Calculi Adolescent Urology medicine.medical_treatment Forceps chemistry.chemical_element Lithotripsy Ureter medicine Ureteroscopy Humans Child medicine.diagnostic_test business.industry Infant Lithotripsy Laser Laser lithotripsy Surgery Endoscopy medicine.anatomical_structure chemistry Child Preschool Ureteroscopes Female Holmium business |
| Zdroj: | BJU international. 94(1) |
| ISSN: | 1464-4096 |
| Popis: | OBJECTIVE To review our experience with rigid ureteroscopy and holmium:YAG laser for treating ureteric calculi in children. PATIENTS AND METHODS The study included 35 children who were treated with rigid ureteroscopy for ureteric calculi between November 1997 and June 2003 (15 boys and 20 girls; mean age 6.2 years, range 1–14). The mean (range) stone size was 8 (4–15) mm and the duration of anaesthesia 46.6 (15–90) min. The stone was in the distal third of the ureter in 33 children and in the proximal third in two. We used a 7.5/8/10 F rigid ureteroscopes with routine dilatation of the ureteric orifice. For lower ureteric stones, lithotripsy was carried out with holmium:YAG laser in 29 cases, a pneumatic impactor in two and forceps extraction in two. Both stones in the proximal ureter were pushed back into the collecting system. All the ureters were stented using JJ stents in 31 and ureteric catheters in four cases. The mean postoperative follow-up was 12 (2–30) months. RESULTS Excluding the two stones pushed back, the stone-free rate after a one-stage procedure was 82% (27/33). With repeated procedures in the six (ESWL in two) remaining cases the success rate was 97% (32/33). The ureter was perforated in two patients within the first five in the series. There was no pyelonephritis or gross haematuria after surgery. CONCLUSION Ureteroscopy and lithotripsy using the holmium:YAG laser is effective and safe for treating ureteric stones in children, in experienced hands. The results would be even better using smaller and flexible ureteroscopes. |
| Databáze: | OpenAIRE |
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