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Vol. 45. Issue 6.
Pages 461-465 (July - August 2021)
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Vol. 45. Issue 6.
Pages 461-465 (July - August 2021)
Original article
Proximal ureteral access for symptomatic stone removal using ultrathin semirigid ureterorenoscope in preschool-age children: Is it possible?
Acceso ureteral proximal para la eliminación de cálculos sintomáticos mediante ureterorrenoscopio semirrígido ultrafino en niños en edad preescolar: ¿es posible?
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Ahmet Burak Doğana,
Corresponding author
abdogan@erciyes.edu.tr

Corresponding author.
, Keramettin Uğur Özkanb, Ahmet Gökhan Gülerc
a Department of Pediatric Surgery, Erciyes University School of Medicine, Kayseri, Turkey
b Department of Pediatric Surgery, Division of Pediatric Urology, Erciyes University School of Medicine, Kayseri, Turkey
c Department of Pediatric Surgery, Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
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Table 1. Patient characteristics.
Table 2. Operational data.
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Abstract
Introduction and Objectives

We aimed to point out the ureteral access facility and obstruction removal efficiency of mini-URS in the use of proximal ureteral stone management in children under five-year-old.

Patients

We retrospectively reviewed the data of 26 children who underwent mini-URS-LL for obstructive stones in proximal ureter between January 2016 and August 2018. The effectiveness of the mini-URS-LL was assessed based on the feasibility, reliability, and success of the technique.

Results

Mean age was 3 ± 1.3 years, and 11 (42.3%) patients were ≤2 years old, remaining 15 (57.7%) were aged 3−5 years. Mean stone size was 9.11 ± 3.02 mm. A stone-free status was obtained at the end of 31 ureteroscopic procedure in 24 (92.3%) patients. The mean age was found significantly higher in patients who had the procedure without pre-stenting than the others who did (P = .027). No perioperative complication was experienced.

Conclusion

In preschool-age children, laser lithotripsy with mini-URS may be a safe technique in the hands with advanced endo-urological skills but it has low efficacy with higher rates of prestenting causing additional anesthesia sessions.

Keywords:
Proximal ureteral stone
Preschool age children
Ultrathin semirigid ureteroscope
Urinary obstruction
Resumen
Introducción y objetivos

Determinar la viabilidad del acceso ureteral y la eficacia de la eliminación de la obstrucción con mini-URS en el manejo de los cálculos ureterales proximales en niños menores de cinco años.

Pacientes

Revisamos retrospectivamente los datos de 26 niños que se sometieron a mini-URS-LL por cálculos obstructivos situados en el uréter proximal entre enero de 2016 y agosto de 2018. La efectividad de mini-URS-LL se evaluó sobre la base de su viabilidad, fiabilidad y el éxito de la técnica.

Resultados

La media de edad fue de 3 ± 1,3 años. Once (42,3%) pacientes tenían ≤2 años y los 15 restantes (57,7%) tenían entre 3 y 5 años. El tamaño medio del calculo era 9,11 ± 3,02 mm. Se obtuvo un estado libre de cálculos al final de 31 procedimientos ureteroscópicos en 24 (92.3%) pacientes. Se encontró que la edad media fue significativamente más alta en los pacientes que se sometieron al procedimiento sin cateterización previa (P = ,027). No se experimentó ninguna complicación perioperatoria.

Conclusión

En niños entre 2 y 5 años, la litotricia laser con mini-URS (mini-URS-LL) puede ser un procedimiento seguro en manos de urólogos expertos en técnicas endourológicas, pero su eficacia es baja, sus tasas de cateterización previa son altas requiriendo consultas de anestesia adicionales.

Palabras clave:
Cálculo ureteral proximal
Niños en edad preescolar
Ureteroscopio semirrígido ultrafine
Obstrucción urinaria

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