Симультанні мініінвазивні втручання в дітей з конкрементами у сечовидільних шляхах

Abstract

Purpose - to substantiate the expediency of simultaneous minimally invasive interventions in children with urolithiasis. Materials and methods. The clinical material covers 7 children aged 5 to 14 years with stones in any part of the pelvicalyceal system and in the lower cystoid of the ipsilateral ureter without congenital anomalies of the urinary tract, which cause urodynamic disorders. In this patients group, the total stones size of the hollow renal system in the longest projection was more than 8 mm and in the lower third of the ureter 5-7 mm, and the stones density - from 750 HU (Hounsfield Units) and above. Results. In patients with urolithiasis, it is necessary to restore urodynamics as quickly as possible, removing all stones from the urinary tract, regardless of their number and location. This is especially important in children, because in this age group the kidney can develop and function only in favorable anatomical and physiological conditions. The problem is exacerbated by the combined stones location in different topical urinary tract areas, in particular, in the ureter and the pelvicalyceal system of the kidney. Simultaneous minimally invasive interventions with the use of contact lithotripsy - percutaneous nephrolithotripsy and ureteroscopy are the most optimal for its solution. Conclusions. Minimally invasive technologies in the treatment of urolithiasis in children are quite safe and allow to perform simultaneous surgery with the contemporaneous removal of all stones from various organs of the urinary system. Preventive drainage of the pelvicalyceal system with a JJ-stent minimizes the clinic of renal colic and creates positive conditions for ureteroscopy. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the listed institution. Informed consent of children and their parents was obtained for the research. No conflict of interests was declared by the authors. Keywords: urolithiasis, ureteroscopy, percutaneous nephrolithotripsy, contact lithotripsy, calculus, children.