Laparoscopic Surgery in Pediatric Upper Tract Urolithiasis: An Alternate Modality
Chhabi Ranu Gupta1, Niyaz Ahmed Khan1, Mamta Sengar1
1Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
Insights
Laparoscopic surgery offers a feasible, radiation-free solution for pediatric upper tract urolithiasis, especially where advanced endoscopic procedures are limited. This minimally invasive approach provides a single-time curative treatment for children with kidney stones.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Laparoscopic Surgery
Background:
- Pediatric urolithiasis (kidney stones) incidence is rising.
- Advanced endoscopic stone removal techniques are often unavailable in developing nations.
- There's a need for accessible, minimally invasive surgical options for pediatric kidney stones.
Purpose of the Study:
- To evaluate the feasibility and outcomes of laparoscopic management for pediatric upper tract urolithiasis.
- To assess the efficacy and safety of laparoscopy as an alternative to traditional open surgery or unavailable endoscopic methods.
Main Methods:
- Retrospective review of 38 pediatric patients with upper tract urolithiasis managed laparoscopically between January 2015 and April 2020.
- Analysis of surgical approach (retroperitoneal vs. transperitoneal) based on stone location.
- Documentation of stone clearance rates, conversion to open surgery, and complications.
Main Results:
- The study included 38 pediatric patients with a mean age of 8 years.
- A 79% stone clearance rate was achieved with laparoscopy alone.
- Eight patients (21%) required conversion to open surgery; no procedure-related complications were reported.
Conclusions:
- Laparoscopic management is a viable, radiation-free, and curative option for pediatric upper tract urolithiasis.
- This approach is particularly beneficial for centers lacking advanced endoscopic lithotripsy facilities.
- Laparoscopy provides a safe and effective minimally invasive surgical solution for pediatric kidney stones.
Introduction:
Incidence of pediatric urolithiasis has increased over the last few decades. Procedures such as extracorporeal short wave lithotripsy, percutaneous nephrolithotripsy, and ureterorenoscopic lithotripsy are not widely available for pediatric age group in many developing countries. It is desirable that advantages of minimally invasive surgery be offered to selected cases with urolithiasis.
Materials And Methods:
All patients with pediatric upper tract urolithiasis managed laparoscopically from January 2015 to April 2020 were retrospectively reviewed.
Results:
A total of 38 patients were included. The mean age of the patients was 8 ± 2.85 years. Thirty-four patients (renal and upper ureteric) were managed through retroperitoneal approach, while those with lower ureteric calculi (n = 4) were approached transperitoneally. A total of eight patients required conversion to open technique. The stone clearance rate was 79% by laparoscopic approach alone. There were no procedure-related complications.
Conclusion:
Our study suggests that laparoscopic management for pediatric upper tract urolithiasis is a radiation-free, single-time curative treatment and is feasible in centers where facilities for other endoscopic procedures are unavailable.
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