PDF herunterladen
Aktuelle Urol 2007; 38(5): 398-402
DOI: 10.1055/s-2006-954991
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Steintherapie im Kindesalter

Stone Management in ChildrenM.  F.  Hamann1 , D.  Melchior1 , K.  P.  Juenemann1 , P.  M.  Braun1
  • 1Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
28. September 2007 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Zusammenfassung

Die Behandlungsmodalitäten in der Therapie der kindlichen Urolithiasis sind einem stetigen Wandel unterworfen. Aufgrund von Effizienz und niedriger Morbidität gilt die ESWL bis heute als Therapie der ersten Wahl bei kindlichen Ureter- und Nierensteinen. Entwicklungen im Bereich minimal invasiver Verfahren eröffnen jedoch zunehmend mehr Behandlungsoptionen. Insbesondere bei der Behandlung distaler Uretersteine muss die extrakorporale Stoßwellenbehandlung als primärer Therapieansatz kritisch überdacht werden. Im Vergleich zur ESWL zeigt die URS in diesem Bereich eine deutlich höhere Effizienz. Auch in der Therapie komplexer und großer Nierensteine sollte vermehrt die Anwendung der mini PCNL erwogen werden. Das Größenverhältnis von Nierenhohlsystem und Instrumentarium limitiert den Einsatz bei Kleinkindern und Säuglingen. Bei geringen Patientenzahlen bleibt die Bereitstellung des Instrumentariums und Anwendung der entsprechenden Techniken größeren Zentren vorbehalten.

Abstract

The extracorporeal shock-wave lithotripsy (ESWL) is still the treatment of choice for almost all stones in children. But with advances in instrumentation, endourological procedures are being performed more frequently in younger patients. Especially in the treatment of distal ureteral stones retrograde ureteroscopy now competes with ESWL. Finally, the recent literature supports percutaneous nephrolithotomy as a safe and effective treatment option for large renal calculi and staghorn calculi. This gives the clinician the opportunity to choose from a wide range of treatment alternatives. Proper treatment planning, technique and availability of appropriate instrumentation are important to achieve an optimal outcome.

Schlüsselwörter

kindliche Urolithiasis - extrakorporale Stoßwellenlithotripsie - Ureterorenoskopie - perkutane Nephrolitholapaxie

Key words

pediatric urolithiasis - extracorporeal shock-wave lithotripsy - retrograde ureteroscopy - percutaneous nephrolithotomy

Literatur

  • 1 Al-Busaidy S S, Prem A R, Medhat M. Pediatric staghorn calculi: the role of extracorporeal shock wave lithotripsy monotherapy with special reference to ureteral stenting.  J Urol. 2003;  169 629-633
    CrossrefPubMedGoogle Scholar
  • 2 Al-Busaidy S S, Prem A R, Medhat M, Al-Bulushi A L. Ureteric calculi in children: preliminary experience with holmium:YAG laser lithotripsy.  BJUI. 2004;  93 1318-1323
    PubMedGoogle Scholar
  • 3 Afshar K, Mclorie G, Papnikoloaou F, Malek R, Harvey E, Pippi-Salle J L, Bagli D J, Khoury A E, Farhat W. Outcome of small residual stone fragments following shock wave lithotripsy in children.  J Urol. 2004;  172 1600-1603
    CrossrefPubMedGoogle Scholar
  • 4 Aksoy Y, Özbey I, Atmaca A F, Polat O. Extracorporal shock wave lithotripsy in children: experience using a mpl-9000 lithotriptor.  World J Urol. 2004;  22 115-119
    PubMedGoogle Scholar
  • 5 Alken P. Harnsteinleiden im Kindesalter. In Hohenfellner R, Thüroff JW, Schulte-Wissermann H (eds). Kinderurologie in Klinik und Praxis. Stuttgart: Thieme 1986: 572-591
    Google Scholar
  • 6 Ather M H, Noor M A, Akhtar S. The effect of intracalyceal distribution on the clearance of renal stones of > or = 20 mm in children after extracorporeal lithotripsy.  BJU Int. 2004;  93 827-829
    CrossrefPubMedGoogle Scholar
  • 7 Bassiri A, Ahmadnia H, Darabi M R, Yonessi M. Transureteral lithotripsy in pediatric practice.  J Endourol. 2002;  16 257-260
    CrossrefPubMedGoogle Scholar
  • 8 Biri H, Kupeli B, Isen K, Sinik Z, Karagolan U, Bozkirli I. Treatment of lower ureteral stones: extracorporeal shockwave lithotripsy or intracorporeal lithotripsy?.  J Endourol.. 1999;  3 (2) 77-81
    PubMedGoogle Scholar
  • 9 Boormans J L, Scheepe J R, Verkoelen C F, Verhagen P C. Percutaneous nephrolithotomy for treating renal calculi in children.  BJU Int. 2005;  95 (4) 631-634
    CrossrefPubMedGoogle Scholar
  • 10 Coward R JM, Peters C J, Duffy P G, Corry D, Kellett M J, Choong S, Hoff W G van't. Epidemiology of paediatric renal stone disease in the UK.  Arch Dis Child . 2003;  88 962-965
    CrossrefPubMedGoogle Scholar
  • 11 Dawaba M S, Shokeir A A, Hafez A T, Shoma A M, El-Sherbiny M F, Mokhtar A, Eraky I, El-Kenawy M, El-Kappany H A. Percutaneous nephrolithotomy in children: early and late anatomical and functional results.  J Urol. 2004;  172 1078-1081
    CrossrefPubMedGoogle Scholar
  • 12 Daudon M, Doré J-C, Jungers P, Lacour B. Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach.  Urol Res. 2004;  32 (3) 241-247
    PubMedGoogle Scholar
  • 13 Desai M. Endoscopic management of stones in children.  Curr Opin Urol. 2005;  15 (2) 107-112
    PubMedGoogle Scholar
  • 14 Desai M, Ridhorkar V, Patel S, Bapat S, Desai M. Pediatric percutaneous nephrolithotomy: assessing impact of technical innovations on safety and efficacy.  J Endourol. 1999;  13 359-364
    PubMedGoogle Scholar
  • 15 Diamond D A, Menon M, Lee P H, Rickwood A M, Johnston J H. Etiological factors in pediatric stone recurrence.  J Urol. 1989;  142 (2 Pt 2) 606-608
    PubMedGoogle Scholar
  • 16 Dogan H S, Tekgul S, Akdogan B, Keskin M S, Sahin A. Use of holmium:YAG laser for ureterolithotripsy in children.  BJUI. 2004;  94 131-133
    CrossrefPubMedGoogle Scholar
  • 17 Dominicis M, Matarazzo E, Capozza N, Collura G, Caione P. Retrograde ureteroscopy for distal ureteric stone removal in children.  BJU Int. 2005;  95 131-133
    CrossrefPubMedGoogle Scholar
  • 18 Esen T, Krutschik A, Alken P. Treatment update on pediatric urolithiasis.  World J Urol. 1997;  15 195-202
    CrossrefPubMedGoogle Scholar
  • 19 Gofrit O N, Pode D, Meretyk S, Meretyk S, Katz G, Shapiro A, Golijanin D, Wiener D P, Shenfeld O Z, Landau E H. Is the pediatric ureter as efficient as the adult ureter in transporting fragments following extracorporeal shock wave lithotripsy for renal calculi larger than 10 mm?.  J Urol. 2001;  166 (5) 1862-1864
    CrossrefPubMedGoogle Scholar
  • 20 Jayanthi V R, Arnold P M, Koff S A. Strategies for managing upper tract calculi in young children.  J Urol. 1999;  162 (3 Pt 2) 1234-1237
    CrossrefPubMedGoogle Scholar
  • 21 Kroovand R L. Pediatric urolithiasis.  Urol Clin North Am. 1997;  24 173-184
    CrossrefPubMedGoogle Scholar
  • 22 Lam J S, Greene T D, Gupta M. Treatment of proximal ureteric calculi: holmium:YAG laser ureterolithotripsy versus ESWL.  J Urol. 2002;  167 1972-1976
    CrossrefPubMedGoogle Scholar
  • 23 Landau E H, Gofrit O N, Shapiro A, Meretyk S, Katz G, Shenfeld O Z, Golijanin D, Pode D. Extracorporeal shock wave lithotripsy is highly effective for ureteral calculi in children.  J Urol. 2001;  165 (6 Pt 2) 2316-2319
    PubMedGoogle Scholar
  • 24 Longo J A, Netto Jr  N R. Extracorporeal shock-wave lithotripsy in children.  Urology. 1995;  46 (4) 550-552
    CrossrefPubMedGoogle Scholar
  • 25 Lottmann H B, Archambaud F, Hellal B, Pageyral B M, Cedron M. 99mTechnetium-dimercapto-succinic acid renal scan in the evaluation of potential long-term renal parenchymal damage associated with extracorporeal shock wave lithotripsy in children.  J Urol. 1998;  159 (2) 521-524
    PubMedGoogle Scholar
  • 26 Lottmann H B, Archambaud F, Traxer O. The efficacy and parenchymal consequences of extracorporeal shock wave lithotripsy in infants.  BJU Int. 2000;  85 311-315
    CrossrefPubMedGoogle Scholar
  • 27 Lottmann H B, Traxer O, Archambaud F, Mercier-Pageyral B. Monotherapy extracorporeal shock wave lithotripsy for the treatment of staghorn calculi in children.  J Urol. 2001;  165 2324-2327
    CrossrefPubMedGoogle Scholar
  • 28 Mahmud M, Zaidi Z. Percutaneous nephrolithotomy in children before school age: experience of a Pakistani centre.  BJU Int. 2004;  94 (9) 1352-1354
    CrossrefPubMedGoogle Scholar
  • 29 Marberger M, Turk C, Steinkogler I. Piezoelectric extracorporeal shock wave lithotripsy in children.  J Urol. 1989;  142 349
    PubMedGoogle Scholar
  • 30 McLorie G A, Pugach J, Pode D, Denstedt J, Bagli D, Meretyk S, D'A Honey R S, Meguerian P A, Shapiro A, Khoury A E, Landau E H. Safety and efficacy of extracorporeal shock wave lithotripsy in infants.  Can J Urol. 2003;  10 2051-2055
    PubMedGoogle Scholar
  • 31 Milliner D S, Murphy M E. Urolithiasis in pediatric patients.  Mayo Clin Proc. 1993;  68 (3) 241-248
    PubMedGoogle Scholar
  • 32 Mor Y, Elmasry Y E, Kellett M J, Duffy P G. The role of percutaneous nephrolithotomy in the management of pediatric renal calculi.  J Urol. 1997;  158 (3 Pt 2) 1319-1321
    CrossrefPubMedGoogle Scholar
  • 33 Musulmanogolu A Y, Tefekli A, Sarilar O, Binbay M, Altunrende F, Ozkuvanci U. Extracorporal Shock Wave Lithotripsy as First Line Treatment Alternative for Urinary Tract Stones in Children: A Large Scale Retrospective Analysis.  J Urol. 2003;  170 2450-2408
    PubMedGoogle Scholar
  • 34 Myers D A, Mobley T B, Jenkins J M, Grine W B, Jordan W R. Pediatric low energy lithotripsy with the Lithostar.  J Urol. 1995;  153 453-457
    CrossrefPubMedGoogle Scholar
  • 35 Netto Jr  N R, Claro J FA, Lemos G C, Contado P L. Treatment option for ureteral calculi: endourology or extracorporeal shock wave lithotripsy.  J Urol. 1991;  146 5-7
    PubMedGoogle Scholar
  • 36 Netto Jr  N R, Longo J A, Ikonomidis J A, Rodrigues Netto M. ESWL in children.  J Urol. 2002;  167 2164-2166
    CrossrefPubMedGoogle Scholar
  • 37 Nijman R J, Ackaert K, Scholtmeijer R J, Lock T W, Schroder F H. Long-term results of extracorporeal shock wave lithotripsy in children.  J Urol. 1989;  142 (2 Pt 2) 609-611
    PubMedGoogle Scholar
  • 38 Onal B, Demirkesen O, Tansu N, Kalkan M, Altintas R, Yalcin V. The impact of caliceal pelvic anatomy on stone clearance after shock wave.  J Urol. 2004;  172 1082-1086
    CrossrefPubMedGoogle Scholar
  • 39 Orsola A, Diaz I, Caffaratti J, Izquierdo F, Alberola J, Garat J M. Staghorn calculi in children: treatment with monotherapy extracorporal shock wave lithotripsy.  J Urol. 1999;  162 (3 Pt 2) 1229-1233
    PubMedGoogle Scholar
  • 40 Ozgur Tan M, Karaoglan U, Sen I, Deniz N, Bozkirli I. The impact of radiological anatomy in clearance of lower calyceal stones after shock wave lithotripsy in pediatric patients.  Eur Urol. 2003;  43 188-193
    CrossrefPubMedGoogle Scholar
  • 41 Pietrow P K, Pope 4th  J C, Adams M C, Shyr Y, Brock 3rd  J W. Clinical outcome of pediatric stone disease.  J Urol. 2002;  167 (2 Pt 1) 670-673
    CrossrefPubMedGoogle Scholar
  • 42 Rizivi S A, Naqvi S A, Hussain Z, Hashimi A, Hussain M, Zafar M, Sulan S, Mehdi H. Management of Pediatric Urolithiasis in Pakistan: Experience With 1,440 Children.  J Urol. 2003;  169 (2) 634-637
    CrossrefPubMedGoogle Scholar
  • 43 Shukla A R, Hoover D L, Homsy Y L, Perlman S, Schurman S, Reisman E M. Urolithiasis in the low birth weight infant: the role and efficacy of extracorporeal shock wave lithotripsy.  J Urol. 2001;  165 (6 Pt 2) 2320-2323
    CrossrefPubMedGoogle Scholar
  • 44 Tan A H, Al-OMar M, Denstedt J D, Razvi H. Ureteroscopy for pediatric urolithiasis: An evolving first-line therapy.  Urology. 2005;  65 (1) 153-156
    CrossrefPubMedGoogle Scholar
  • 45 Tan A H, Al-OMar M, Watterson J D, Nott L, Denstedt J D, Razvi H. Results of shockwave lithotripsy for pediatric urolithiasis.  J Endourol. 2004;  18 (6) 527-530
    CrossrefPubMedGoogle Scholar
  • 46 Tiede J M, Lumpkin E N, Wass C T, Long T R. Hemoptysis following extracorporeal shock wave lithotripsy: a case of lithotripsy-induced pulmonary contusion in a pediatric patient.  J Clin Anesth. 2003;  15 530-532
    CrossrefPubMedGoogle Scholar
  • 47 Van Savage J G, Palanca L G, Andersen R D, Rao G S, Slaughenhoupt B L. Treatment of distal ureteral stones in children: similarities to the American urological association guidelines in adults.  J Urol. 2000;  164 (3 Pt 2) 1089-1093
    CrossrefPubMedGoogle Scholar
  • 48 Wollin T A, Teichman J M, Rogenes V J, Razvi H A, Denstedt J D, Grasso M. Holmium: YAG lithotripsy in children.  J Urol. 1999;  152 1714-1716
    PubMedGoogle Scholar
  • 49 Zeren S, Satar N, Bayazit Y, Bayazit A K, Payasli K, Ozkeceli R. Percutaneous nephrolithotomy in the management of pediatric renal calculi.  J Endourol. 2002;  16 (2) 75-78
    CrossrefPubMedGoogle Scholar

Dr. Moritz Hamann

Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel

Arnold-Heller-Straße 7

24105 Kiel

eMail: mhamann@urology.uni-kiel.de

      >