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The management of staghorn calculi in children
1Department of Urology, Kartal Training Hospital, Istanbul, Turkey.
Insights
Percutaneous nephrolithotomy (PCNL) and electrohydraulic shockwave therapy (ESWL) are effective treatments for pediatric staghorn stones. PCNL is the preferred first-line option, with ESWL and open surgery as secondary choices.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Management
Background:
- Staghorn calculi in children pose a significant challenge in urological practice.
- Despite advancements, effective management of pediatric urolithiasis remains an area of focus.
Purpose of the Study:
- To review surgical treatment options for pediatric staghorn stones.
- To evaluate current knowledge on managing staghorn calculi in children.
Main Methods:
- Literature search of PubMed (1991-2011) using keywords: staghorn stone, child, kidney calculi, surgical treatment, ESWL, PCNL, open surgery.
- Inclusion of reports on general pediatric stone disease treatment.
- Cross-referencing from retrieved articles.
Main Results:
- Open surgery is now indicated only for highly selected pediatric patients.
- Percutaneous nephrolithotomy (PCNL) and electrohydraulic shockwave therapy (ESWL) are effective for pediatric staghorn calculi in experienced centers.
- Both PCNL and ESWL demonstrate efficacy in treating pediatric staghorn stones.
Conclusions:
- Advanced techniques allow safe and successful treatment of pediatric staghorn calculi.
- Percutaneous nephrolithotomy (PCNL) is the recommended first-line surgical treatment.
- Electrohydraulic shockwave therapy (ESWL), open surgery, and combined methods serve as valuable secondary treatment options.
Objectives:
To review reports focusing on the surgical treatment of staghorn stones in children, as despite all the improvements in the surgical treatment of paediatric urolithiasis the management of staghorn calculi still represents a challenging problem in urology practice.
Methods:
To evaluate current knowledge about treating staghorn calculi in children, we searched PubMed for relevant articles published between 1991 and 2011, using a combination of related keywords, i.e. staghorn stone, child, kidney calculi, surgical treatment, electrohydraulic shockwave therapy (ESWL), percutaneous nephrolithotomy (PCNL), and open surgery. Reports relating to the treatment of paediatric stone disease in general (open surgery, PCNL, ESWL) were also searched with the same method. Additional references were obtained from the reference list of full-text reports.
Results:
Although open surgery had been widely used in the past for treating such stones in children, currently it has only limited indications in highly selected patients. Current published data clearly indicate that, in experienced hands, both PCNL and ESWL are now effective methods for treating staghorn calculi in children.
Conclusions:
Due to advanced techniques and instrumentation, it is now possible to successfully treat staghorn calculi in children, with very limited safety concerns. Currently, while PCNL is recommended as the first-line surgical treatment, ESWL, open surgery and/or combined methods are valuable but secondary options in the treatment of paediatric staghorn calculi.
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