Tong Fangyun,Zhao Yaowang,Liu Li,et al.Efficacy analysis of extracorporeal shock wave lithotripsy combined with tail-thread DJ stent placement in the treatment of pediatric renal calculi[J].Journal of Clinical Pediatric Surgery,,():683-686.[doi:10.3760/cma.j.cn101785-202503015-015]
Efficacy analysis of extracorporeal shock wave lithotripsy combined with tail-thread DJ stent placement in the treatment of pediatric renal calculi
- Keywords:
- Kidney Calculi; Extracorporeal Shockwave Therapy; Urinary Tract; Surgical Procedures; Operative; Child
- Abstract:
- Objective To preliminarily explore the clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) in treating pediatric renal calculi. Methods A retrospective analysis was conducted on the clinical data of 44 children with renal calculi treated at the Department of Urology,Hunan Children’s Hospital,between January 2019 to November 2024.All 44 patients underwent ESWL combined with tail-thread DJ stent placement.The stone-free rate (SFR) after a single procedure and postoperative complications such as hematuria and fever were recorded. Results After the first ESWL session,33 patients achieved complete stone fragmentation,yielding an SFR of 75% (33/44).The remaining 11 cases (25%) had residual stones and subsequently underwent ureteroscopic lithotripsy.Postoperatively,24 children experienced hematuria,which resolved spontaneously within 24-36 hours.6 children developed fever due to presumed urinary tract infection,and all returned to normal temperature after anti-infective therapy.Stone composition analysis was performed in 12 cases:calcium oxalate monohydrate in 10,ammonium urate in 1,and carbonate apatite mixed with hydroxyapatite in.During a follow-up of 3 months to 3 years,no stone recurrence was observed. Conclusions ESWL is a safe and effective treatment for pediatric renal calculi.Tail-thread DJ stent placement aids in ureteral dilation and facilitates stone expulsion.
References:
[1] Burgos Lucena L,Fernández Bautista B,Parente Hernández A,et al.Extracorporeal shock wave lithotripsy and combined therapy in children:efficacy and long-term results[J].Front Pediatr,2021,9:609664.DOI:10.3389/fped.2021.609664.
[2] Stamatiou KN,Heretis I,Takos D,et al.Extracorporeal shock wave lithotripsy in the treatment of pediatric urolithiasis:a single institution experience[J].Int Braz J Urol,2010,36(6):724-731.DOI:10.1590/s1677-55382010000600011.
[3] Unal U,Deniz ME,Ortoglu F,et al.What is the best approach for pediatric kidney stones of moderate-sized between shock wave lithotripsy,ultramini percutaneous nephrolithotomy and retrograde intrarenal surgery?[J].Pediatr Surg Int,2022,38(11):1643-1648.DOI:10.1007/s00383-022-05203-1.
[4] 覃峰,何天衢,赵夭望,等.CT HU值判断小儿泌尿系结石成分的应用探讨[J].临床小儿外科杂志,2024,23(1):40-45.DOI:10.3760/cma.j.cn101785-202304043-008. Qin F,He TQ,Zhao YW,et al.Application of computed tomography Hounsfield unit in the determination of urinary stone composition in children[J].J Clin Ped Sur,2024,23(1):40-45.DOI:10.3760/cma.j.cn101785-202304043-008.
[5] Tsai SH,Chung HJ,Tseng PT,et al.Comparison of the efficacy and safety of shockwave lithotripsy,retrograde intrarenal surgery,percutaneous nephrolithotomy,and minimally invasive percutaneous nephrolithotomy for lower-pole renal stones:a systematic review and network meta-analysis[J].Medicine (Baltimore),2020,99(10):e19403.DOI:10.1097/MD.0000000000019403.
[6] Basuguy E,?nen A,Azizo?lu M,et al.Effectiveness of extracorporeal shock wave lithotripsy in urolithiasis patients under 2 years of age[J].Cir Cir,2023,91(5):620-626.DOI:10.24875/CIRU.22000548.
[7] Vinit N,Khoury A,Lopez P,et al.Extracorporeal shockwave lithotripsy for cystine stones in children:an observational,retrospective,single-center analysis[J].Front Pediatr,2021,9:763317.DOI:10.3389/fped.2021.763317.
[8] Bosnali E,Mutlu N,Cakmak K,et al.Effects of double J stent (DJS) placement before pediatric ESWL on complications and stone-free rates[J].J Pediatr Surg,2025,60(5):162274.DOI:10.1016/j.jpedsurg.2025.162274.
[9] Snicorius M,Bakavicius A,Cekauskas A,et al.Factors influencing extracorporeal shock wave lithotripsy efficiency for optimal patient selection[J].Wideochir Inne Tech Maloinwazyjne,2021,16(2):409-416.DOI:10.5114/wiitm.2021.103915.
[10] Jee JY,Kim SD,Cho WY.Efficacy of extracorporeal shock wave lithotripsy in pediatric and adolescent urolithiasis[J].Korean J Urol,2013,54(12):865-869.DOI:10.4111/kju.2013.54.12.865.
[11] Guler Y,Erbin A.Comparison of extracorporeal shockwave lithotripsy and retrograde intrarenal surgery in the treatment of renal pelvic and proximal ureteral stones ≤2 cm in children[J].Indian J Urol,2020,36(4):282-287.DOI:10.4103/iju.IJU_116_20.
[12] Chatzikrachtis N,Tzelves L,Geraghty R,et al.Complication rate after pediatric shock wave lithotripsy according to Clavien-Dindo grading system:results from a systematic review and meta-analysis of the existing literature[J].World J Urol,2023,41(3):829-835.DOI:10.1007/s00345-022-04267-x.
Memo
收稿日期:2025-3-5。
基金项目:国家自然科学基金(82203414);湖南省卫生健康委科研计划项目(B202304057979);湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017);湖南省自然科学基金(2023JJ40347)
通讯作者:赵夭望,Email:yw508@xinlang.com