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Minimally invasive approaches and their efficacy in pediatric urolithiasis
Ramazan Altıntaş1, Ali Beytur1, Fatih Oğuz1
1Department of Urology, Faculty of Medicine, İnönü University, Malatya, Turkey.
Insights
Extracorporeal shock wave lithotripsy (ESWL) showed the highest success rate in treating pediatric kidney stones, followed by ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL). Minimally invasive techniques are preferred for pediatric urolithiasis management.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Technology
Background:
- Pediatric urolithiasis management requires effective and minimally invasive treatment options.
- Recurrence rates in pediatric stone disease necessitate careful therapeutic planning.
Purpose of the Study:
- To compare the usage frequency and success rates of minimally invasive treatments for pediatric urolithiasis.
- To evaluate percutaneous nephrolithotomy (PNL), ureterorenoscopy (URS), and extracorporeal shock wave lithotripsy (ESWL) in pediatric patients.
Main Methods:
- Retrospective analysis of pediatric patients (≤16 years) treated between 2001-2011.
- Inclusion of patients undergoing PNL, URS, or ESWL for renal and ureteral stones.
- Evaluation of 415 patients with 291 renal and 124 ureteral stones.
Main Results:
- Stone-free rates were 77% for PNL, 83.8% for URS, and 88.7% for ESWL.
- ESWL demonstrated the highest stone-free rate among the evaluated minimally invasive procedures.
- PNL, URS, and ESWL are highly successful in treating pediatric stones, reducing the need for open surgery.
Conclusions:
- Minimally invasive approaches, including ESWL, PNL, and URS, are highly effective for pediatric urolithiasis.
- Proper planning of selected therapies is crucial for optimal outcomes in pediatric stone management.
- High success rates of minimally invasive techniques limit the use of open surgery in pediatric urolithiasis.
Objective:
We compared the frequency of usage and success of minimally invasive approaches in the management of pediatric urolithiasis in our clinic.
Material And Methods:
Data from pediatric patients (≤16 years of age) who had undergone percutaneous nephrolithotomy (PNL), ureterorenoscopy (URS), and extracorporeal shock wave lithotripsy (ESWL) between January 2001 and December 2011 were retrospectively investigated.
Results:
In this study, 415 pediatric patients, who were treated for 291 renal, and 124 ureteral stones, were evaluated. The patients were treated with PNL (n=148; 82 boys, 66 girls), URS (n=99; 58 boys, and 41 girls) or ESWL (n=168; 91 boys, and 77 girls). The mean patient ages were 7.3 (1-16), 9.1 (1-16), and 8.8 (1-16) years in the PNL, URS, and ESWL groups, respectively. The stone-free rates after treatment with PNL, URS, and ESWL were 77, 83.8 and 88.7%, respectively.
Conclusion:
It is important that selected therapies are properly planned, and the use of minimally invasive approaches is important in pediatric patients due to potentially high recurrence rates. Currently, ESWL, PNL and URS are performed with high success rates for the treatment of stones, and open surgery is rarely used due to the success obtained with minimally invasive approaches.
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