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Minimally-invasive techniques in the management of childhood | 54189

形成外科: ケーススタディ

概要

Minimally-invasive techniques in the management of childhood bladder diseases

Dmytro Shevchuk

Introduction : Bladder tumours are a very rare condition in pediatric age. That is why true and accurate information on biological grade and, respectively, the surgical management is absent. However, the majority of physicians take the view that this type of tumour has a low grade of malignization and recurrence, even after the endoscopic excision of neoplasm, in paediatric age.
Objective : To describe a possibilities of surgical management of the bladder tumors in a childs by means of minimally invasive equipment.
Material and methods : Endoscopic methods of surgical treatment are widely used in the pediatric patients with the urinary tract conditions in the department of surgery No. 2 of the Zhytomyr Oblast’s Children’s Clinical Hospital. The transcutaneous surgical treatment of bladder conditions has been employed in paediatric age since 2010. It was used for different cases (for the removal of impacted vesical calculus, the foreign bodies of bladder and the excision of bladder urothelial neoplasm). We also tried to use it for the visualisation of the posterior urethra rupture length through the cystoscope, which was put into the epicystostomic hole of the posterior urethra together with the simultaneous urethroscopy (for the purpose of the directed illumination during the urethroscopy). However, due to the long length of the posttraumatic urethrostenosis it was impossible to achieve the illumination and the catheterisation of urethra during the urethroscopy in the site of damage.
Results : The clinical cases of the minimally invasive treatment for the bladder diseases in a childs are presented.
Conclusion : Minimally invasive techniques give the opportunity to perform even the radical operations with the perfect cosmetic result and minimal injury that is very important in the pediatric age.