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Rigid ureteroscopy in children: Our experience
Venkat Sripathi1, Sujit K Chowdhary2, Deepak K Kandpal2
1Department of Pediatric Urology and Pediatric Surgery, Apollo Children's Hospital, Chennai, Tamil Nadu, India.
Insights
Pediatric ureterorenoscopy is a safe and effective treatment for ureteric calculi (stones) in children. This study confirms its efficacy even in very young patients, supporting endoscopic management for pediatric ureteral stones.
Area of Science:
- Pediatric Urology
- Endourology
- Pediatric Surgery
Background:
- Ureteric calculi in children present a unique management challenge.
- Minimally invasive techniques are preferred for pediatric stone disease.
Purpose of the Study:
- To evaluate the safety and efficacy of pediatric ureterorenoscopy for ureteric calculi.
- To report experience from two tertiary pediatric urology centers.
Main Methods:
- Retrospective analysis of pediatric patients with symptomatic ureteric stones > 6 mm.
- Exclusion criteria included age < 12 months or > 18 years, and non-stone indications for ureterorenoscopy.
- Standardized investigative and treatment protocols were applied.
Main Results:
- Thirty-eight children underwent ureterorenoscopy (20 in Chennai, 18 in New Delhi).
- Mean ages were 10.4 (Chennai) and 8.5 (New Delhi) years; youngest patients were 14 and 24 months.
- Only one conversion to open surgery occurred in each group; pneumatic lithotripsy and holmium laser were utilized.
Conclusions:
- This is the largest Indian series on pediatric ureterorenoscopy for ureteric calculi.
- The study confirms the safety and efficacy of ureterorenoscopy in children, including younger age groups.
- Pre-stenting and delayed ureterorenoscopy facilitate safe endoscopic treatment for ureteric calculi in children under five years.
Aim:
To report our experience of Pediatric ureterorenoscopy for ureteric calculi from two tertiary Pediatric urology centers at Apollo Children's Hospital, Chennai and Indraprastha Apollo Hospital, New Delhi.
Material And Methods:
All children who presented with symptomatic ureteric stones greater than 6 mm were entered into the study. All children less than 12 months and more than 18 years of age and those who underwent ureterorenoscopy for indications other than the stones were excluded from the study. The children were managed on a fixed investigative and treatment protocol. The data from the Apollo Hospital New Delhi and Apollo Children's Hospital Chennai was analysed.
Results:
There were a total of thirty eight children, twenty in Chennai and eighteen in the New Delhi study. The mean age was 10.4 years and 8.5 years and the youngest child was14 months and 24 months in the Chennai and New Delhi group respectively. There was one conversion to open surgery in either group. Pneumatic lithotripter was used in majority of cases and holmium laser in select children.
Conclusion:
This is the largest Indian series of ureterorenoscopy for ureteric calculi in children. This study over nearly a decade confirms the safety and efficacy of this technique even in young children. In children less than five years, prestenting and delayed ureterorenoscopy allows safe endoscopic treatment of ureteric calculi.
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