IMCAS

Bartlomiej SOBOLEWSKI 医师

美容整型外科医师

波兰

"I am a specialist in anesthesiology and intensive care, as well as an aesthetic medicine practitioner. I also serve as a Key Opinion Leader (KOL) for collagen stimulators based on PDLLA. Additionally, I am honored to be a trainer for Vivacy and Aptos. I am the founder and owner of a network of aesthetic medicine clinics in Poland. My expertise involves developing proprietary procedures that integrate advanced treatments from regenerative and aesthetic medicine. I frequently employ a combination of medical peels, physical methods, predominantly fractional and ablative laser therapies, along with various platelet-rich plasma formulations to optimize the revitalization effects on facial and body skin. Furthermore, I have a keen interest in radiofrequency applications for both rejuvenation and body contouring."

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Bartlomiej SOBOLEWSKI's 的发布 (2)

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®).

2021

Kidney stone disease in children is always a therapeutic challenge. It is a multifactorial condition and it should be approached, diagnosed and treated as such. One of the biggest challenges is kidney stones located in the lower renal calyx. There are currently three main surgical techniques to treat this condition: ESWL-Extracorporeal Shock Wave Lithotripsy, RIRS-Retrograde IntraRenal Surgery, and PCNL-PerCutaneous Nephro-Lithotripsy. In pediatric population, the most frequently used method is ESWL, and in the event of failure, endoscopic procedures are the second-best choice. In this article, a sample of 53 children admitted to a tertiary medical center was examined. Thirty-eight of those children underwent flexible URS, while the remaining 15-micro PCNL. The average size of the deposit in the former group was 12.2 mm, against 13.5 mm in the latter. The full Stone Free Rate (SFR) was achieved in RIRS at 84.21 and 86.7% in percutaneous nephrolithotripsy. Flexible ureterorenoscopy and MicroPERC are two comparably effective methods for treating lower calyx stones of any size. However, according to our data, flexible ureterorenoscopy carries a lower risk of complications and inpatient care (with the mean of 3 days). The learning curve for these procedures in pediatric urology is long and relies on a limited number of patients. The number of pediatric patients qualifying for these procedures is restricted also due to the high efficacy of extracorporeal shock wave lithotripsy in pediatric population. Radiation exposure is an important factor in every endoscopy procedure and should never exceed the limits set in the ALARA protocol. ESWL remains to this day the treatment of choice for stone disease in children and can be performed under ultrasound control. For many parents, it is a first-choice treatment preference for their child due to its greater apparent safety, although data on this remains insufficient. Prospective, randomized, multicenter trials are definitely needed. 更多详情

Frontiers in pediatrics

Interest of URS-L in the Treatment of Ureterolithiasis in Preschool Children.

2019

Urolithiasis can affect all children even preschool ones. Diagnostic difficulties in the youngest children are due to the problems in locating pain and determining its character and severity. In keeping with the ALARA (As Low As Reasonably Achievable) protocol, the number of imaging tests possible to perform is very limited. Ultrasound is the first line exam of choice. After diagnosis of the presence of a stone, ESWL (Extracorporeal Shock Wave Lithotrypsy) should always be considered and offered to parents due to its high effectiveness and minimal invasiveness. If ESWL is contraindicated or not well-accepted by parents, authors suggest another minimal invasive approach: URS-L (Uretherorenoscopy-Lithotrypsy). Our study clinically analyzes 87 children, which were treated between 2009 and 2017 using the URS-L procedure. URS-L treatments were performed using Lithoclast until 2009, and after that time, using the holmium laser Ho:YAG. The overall effectiveness of treatments was 93.3%. There was no failure in the access to the stones. A macroscopic hematuria (Clavien-Dindo I grade) was observed through the second post-operative day in 9.2% of treated patients. No urosepsis was observed. Full metabolic evaluation was performed on all patients. Children remained under constant urological and nephrological observation. A recurrence of urolithiasis was observed in 35.6% of the cases. Treating ureteral lithiasis in young infants remains a big challenge. Our series shows that modern minimal invasive techniques used by very experienced pediatric urologists in high volume centers gives excellent results. In most cases, surgery should no longer need to be an option. 更多详情

Frontiers in pediatrics

Bartlomiej SOBOLEWSKI 医师

Bartlomiej SOBOLEWSKI's 的发布 (2)

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®).

Interest of URS-L in the Treatment of Ureterolithiasis in Preschool Children.

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