Ureteroscopic lithotripsy for treatment of ureteral calculi in children: Efficacy and safety / 第二军医大学学报

ABSTRACT

Objective: To assess the efficacy and safety of the ureteroscopic lithotripsy in treatment of ureteral calculi in children. Methods, From March 2008 to May 2009, thirteen pediatric patients with ureteral stones were admitted to our department. There were six males and seven females, with an age range of 23 months to 11 years old. Six patients with stones located at the lower segments of the ureter, four at the middle segments, two at the upper segments, and one at pyelo-ureteral junction and lower ureter. The average diameter of the stones was (1.1 ± 0.47) cm (range 0.6 - 2.0 cm). The patients were placed in a lithotomy position; under general or venous anesthesia, ureteroscopy was performed using a semirigid ureteroscope (WOLF Fr 7.5/6), and the ureteral orifice was dilated to 10-12 Fr. Then holmium laser (1.5 J, 10 Hz) or pneumatic lithotripter was employed to fragment the stones (diameter of fragment less than 3 mm). Fr4. 7 double-J stent was placed after operation and was removed 4 weeks later. Results: Eleven of the 13 patient underwent successful lithotripsy, with the first time successful rate being 84.6%. The mean lithotripsy time was 8 min and the mean operation time was 21 min. There was slight bleeding during operation, but with no noticeable perforation of ureter or post operation fever, etc. Post-operation B ultrasound examination and X ray image revealed no residual stones with diameter > 3 mm in the 11 cases. Partial fragmentation was achieved in one patient with stone at upper ureter segment and one patient with stone at pyelo-ureteral junction and lower ureter, and the stones were excreted after extracorporreal shock wave lithotripy. Conclusion: Ureteroscopic lithotripsy is safe and effective in treatment of children with ureteral stones, which might become one of the first line treatment for children.