Ureteroscopy for Treatment of Upper Urinary Tract Stones in Children: Technical Considerations

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• 作者：Natasha Gupta (1)
  Joan Ko (3)
  Brian R. Matlaga (3)
  Ming-Hsien Wang (2)
  
• 关键词：Kidney calculi/surgery ; Surgical procedures ; Minimally invasive/methods ; Ureteroscopy/methods ; Ureteroscopes ; Treatment outcome
• 刊名：Current Urology Reports
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：15
• 期：5
• 全文大小：140 KB
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• 作者单位：Natasha Gupta (1)
  Joan Ko (3)
  Brian R. Matlaga (3)
  Ming-Hsien Wang (2)
  
  1. The Johns Hopkins University School of Medicine, 733 North Broadway Street, Baltimore, MD, 21205, USA
  3. The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA
  2. Division of Pediatric Urology, The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA
  
• ISSN：1534-6285

文摘

The incidence of pediatric urolithiasis is increasing. While many smaller stones may pass spontaneously, surgical therapy is sometimes warranted. Surgical options include shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, and open surgery. Ureteroscopy represents a minimally invasive approach, and it is increasingly being used to treat pediatric upper tract calculi. Ureteroscopy is performed under anesthesia and fluoroscopic guidance, with basket extraction or lithotripsy of the calculi. Technical considerations include active or passive ureteral dilatation, the use of ureteral access sheaths for larger stone burdens, and post-operative stent placement. The current pediatric literature suggests high success rates (equal to or surpassing shock wave lithotripsy) and low complication rates. However, concerns remain regarding feasibility in patients with variant anatomies and risk due to intra-operative radiation exposure.