无管化经尿道输尿管镜下2 μm激光联合第四代EMS系统治疗小儿输尿管囊肿合并结石

1.解放军252医院泌尿外科(河北省保定市,071000); 2.保定市儿童医院外五科(河北省保定市,071000); 3.解放军总医院泌尿外科(北京市100853)

儿童; 输尿管膨出; 结石; 激光; 无管化

Tubeless measurement of transurethral ureteroscopic 2 μm laser vaporesection plus fourth generation Swiss LithoClast Master lithotripsy for ureterocele with calculi in children.
Han Gang1,Yang Bin2,Li Chao1,Chen Yudong1,Ma Yaqing1,Yu Jianmei1,Sun Na1,Duan Dongchao1,Zhang Jinlei1,Mei Guangming1,Bai Xinyu1,Bai Xu

1. Department of Urology,PLA No.252 Hospital,Baoding 071000,China; 2. Department of Urology,Municipal Children's Hospital,Baoding 071000,China; 3. Department of Urology,PLA General Hospital,Beijing 100853,China

Child; Ureterocele; Calculi; Lasers; Tubeless

DOI: 10.3969/j.issn.1671— 6353.2018.05.008

备注

目的 探讨经尿道输尿管镜下2 μm激光联合第四代EMS治疗小儿输尿管囊肿合并结石的可行性。方法 对23例接受经尿道输尿管镜下2 μm激光低位开窗+碎石清石术治疗的小儿输尿管囊肿合并结石患儿的临床资料进行回顾分析。患儿年龄1~8岁,中位年龄2.5岁。经尿道置入F8/9.8输尿管镜,以2 μm激光手术系统行囊肿低位开窗术,再以EMS系统碎石清石。术后不留置输尿管支架管及尿管,观察临床效果。结果 全部病例顺利完成手术,术后无明显并发症,如期出院。随访期间未见输尿管囊肿或结石复发。结论 经尿道输尿管镜下2 μm激光联合第四代EMS系统治疗小儿输尿管囊肿合并结石具有出血少、操作安全简便等优点,无管化方案可进一步减少手术创伤,减轻术后不适感,加快康复进程,是一种安全、可靠的微创手术方法。
Objective To explore the feasibility of tubeless measurement of 2 μm laser vaporesection plus Swiss LithoClast Master lithotripsy under ureteroscopy for pediatric ureteroceles with calculi. Methods A total of 23 cases of ureteroceles undergoing tubeless 2 μm laser vaporesection and lithotripsies by ureteroscopy were reviewed.The median age was 2.5(1~7)years.RevoLix 2 μm laser system and fourth generation Swiss LithoClast Master were performed through ureteroscopy without ureter stents and catheter indwelling. Results All operations were successfully performed.And no serious postoperative complications occurred.No recurrence of ureterocele or calculi was observed. Conclusion Tubeless transurethral 2 μm laser and Swiss LithoClast Master treatment under ureteroscopy are superior to mini-invasive surgery for children with ureterocele and calculi.And the advantages are minimal blood loss,high safety,convenient operation and infrequent complications.Tubeless method can further attenuate surgical wound and postoperative recovery.