小児尿路石の体外ショック波リトトリプシー 生きている ≤1.0cm2
Sinharib Çitgez1, Elif Altınay Kırlı1, Muhammet Demirbilek2
1Cerrahpaşa Faculty of Medicine, Department of Urology, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
Journal of endourology
|September 3, 2025
まとめ
外体ショック波リトトリプシー (SWL) と尿管顕微鏡 (URS) は,小児尿路石の1.0cm2までの無結石率に類似しています. SWLは,特に遠隔結石の場合,より低い合併症率のため,好ましい第一線オプションです.
科学分野:
- 小児泌尿器科
- エンドウロロジー
- ネフロリチアシスの治療
背景:
- 小児の尿路石は,効果的で安全な治療法が必要です.
- 外体ショック波リトトリプシー (SWL) と尿管顕微鏡 (URS) は一般的な介入です.
- 小児性尿路石 (≤1. 0cm2) のアウトカムに関する比較データは,臨床決定の指針として極めて重要です.
研究 の 目的:
- 尿路結石 ≤1. 0cm2の子供のSWLとURSの臨床評価を比較する.
- 石抜き率と合併症プロファイルに基づいて最適の治療戦略を特定する.
主な方法:
- 尿路結石 ≤1. 0cm2の230人の小児患者の遡及研究
- 治療には,SWL (鎮静) とURS (Ho:YAGレーザーリトトリプシーによる全身麻酔) が含まれていた.
- 合併症は標準的な基準 (SWLはSatava,URSはClavien) を用いて評価された.
主要な成果:
- SWL (n=129) とURS (n=101) は,比較可能な石抜き率を示した (85%対80%,p=0. 276).
- URSは,特に遠端結石において,全体的な合併症率 (16%対4%,p=0. 005) を著しく高めた.
- 女性の性別と石の負担は,石の無い状態の重要な予測要因として特定されました.
結論:
- SWLとURSは,小児の尿路石の除去に等しく有効である.
- URSは,特に遠端尿路結石の合併症の増加と関連しています.
- SWLはこれらの石の第一線治療として推奨され,URSは特定のケースに予約されています.
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