a litotripsia extracorpórea no tratamento de cálculos urinários em crianças extracorporeal lithotripsy for the treatment of urolithiasis in children

Clicks: 322
ID: 226301
2002
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Abstract
Objetivo: cálculos urinários atingem de 5 a 10% da população em alguma fase da vida. Destes casos, somente 2 a 3% são crianças. O tratamento da litíase urinária na faixa pediátrica, com o uso de métodos minimamente invasivos, representa uma alternativa cada vez mais atraente. O presente trabalho objetiva apresentar resultados de litotripsia extracorpórea como tratamento minimamente invasivo de litíase urinária na infância. Métodos: no período de setembro de 1991 a setembro de 2000, foram tratadas e acompanhadas 87 crianças, sendo que seis delas tinham dois cálculos; portanto foram tratados 93 cálculos urinários. Foi utilizado o equipamento de litotripsia extracorpórea por ondas de choque, da Dornier-Philips. Resultados: os cálculos piélicos, caliciais superiores e médios foram fragmentados e eliminados na porcentagem de 87,7% e 77,8%, respectivamente. Os cálculos localizados no cálice inferior foram eliminados em 64,7%. Dos três casos de cálculo coraliforme, somente um ficou livre do cálculo (33,3%). Os dez pacientes com cálculo ureteral ficaram livres de litíase (100%). Os cálculos vesicais foram tratados e eliminados em 60% dos casos. Conclusão: a litotripsia extracorpórea demonstrou ser uma forma eficiente de tratamento de cálculos piélicos, caliciais, ureterais e vesicais em crianças. Cálculos coraliformes não tiveram bons resultados quando tratados por meio de litotripsia extracorpórea. Os resultados deste método foram influenciados pela localização e tamanho dos cálculos.
Objective: urolithiasis affects between five and 10% of the human population during their lifetime, only 2-3% of whom are children. Therapy of urolithiasis in the pediatric age group with minimally invasive methodology represents an attractive alternative. This study presents results of extracorporeal shockwave lithotripsy, a minimally invasive methodology, for the treatment of urolithiasis in children. Methods: in the period between September 1991 and September 2000, 87 children were submitted to extracorporeal shockwave lithotripsy; as six of them presented with two calculi 93 urinary calculi were treated over that period. The Dornier-Philips lithotriptor was used in the procedures. Results: pelvic, superior and medium caliceal calculi were fragmented and eliminated in 87.7% and 77.8% of cases, respectively. Inferior caliceal stones were eliminated in 64.7% of cases. Only one of the three patients with staghorn calculi became stone-free after therapy (33.3%). All patients with ureteral calculi were stone-free after therapy. Bladder stones were fragmented and eliminated in 60% of cases. Conclusions: extracorporeal shockwave lithotripsy is a safe and effective treatment for pelvic, caliceal, ureteral and bladder urolithiasis in children. Staghorn calculi have not shown satisfactory results when treated by this method. Extracorporeal shockwave lithotripsy results were influenced in our experience by the position and size of the treated calculi.
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Authors ;Ricardo J. Duarte;Anuar I. Mitre;Francisco T. Dénes;Amilcar M. Giron;Vera Koch;Sami Arap
Journal sports (basel, switzerland)
Year 2002
DOI
10.1590/S0021-75572002000500005
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572002000500005
Keywords
Children urolithiasis therapy tratamento

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