What changed in the management of pediatric stones after the introduction of minimally invasive procedures? A single-center experience over 24 years

Önal, Bülent; Çitgez, Sinharib; Tansu, Nejat; G, Emin; Demi̇rkesen, Oktay; Talat, Zübeyr; Yalçın, Veli; Erözenci, Ahmet

doi:10.1016/j.jpurol.2012.12.015

Cited by 40 publications

(25 citation statements)

References 8 publications

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“…The treatment of pediatric renal stone has been changed since the introduction of endoscopic surgery. There are more patients being treated, and the patients being younger, while open surgery is no longer a first option [6]. In some center, open surgery is never required in primary lithiasis cases without associated malformations [7].…”

Section: Discussionmentioning

confidence: 99%

The application of S.T.O.N.E. nephrolithometry in pediatric patients with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy

et al. 2015

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The purpose of this study is to verify the applicability of S.T.O.N.E. nephrolithometry in pediatric patients. 103 cases of pediatric patients younger than 4 years old with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy from January 2012 to March 2014 were retrospectively reviewed and evaluated using this scoring system. All procedures were performed under general anesthesia, using a 14-French nephroscope through a 16-French working access. All patients were divided into two groups according to the stages of the operations, Group A for one-stage operation and Group B for two-stage operation. 87 cases were male and 16 cases were female with the mean age of 26.5 months. The total operation time of group A was 45.89±5.43 min, and 54.62±5.58 min of group B (p=0.000). The hospitalization for group A and group B was 6.63±1.34 and 7.23±1.24 days, respectively (p=0.134). The total S.T.O.N.E. score was 5.93±0.67 for Group A, and 7.92±1.04 for Group B (p=0.000). On further dividing each group into low/moderate/high complexity according to the total score, more cases of low/moderate complexity in group A and more cases of moderate/high complexity in group B (χ2=38.096, p=0.000) were reported. Our data suggest that S.T.O.N.E. nephrolithometry is applicable in pediatric upper urinary tract calculi assessment and predictive for the complexity of the operation, hospitalization, and even complications after the operation. Yet modification may be necessary to make this scoring system more distinguishable for pediatric cases.

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Section: Discussionmentioning

confidence: 99%

The application of S.T.O.N.E. nephrolithometry in pediatric patients with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy

et al. 2015

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“…In one recent study, endourological management of all paediatric urolithiasis increased from 24.1% in the late 1980s/early 1990s to 99.8% from 2005 to 2010 [6]. Open surgery is now rarely used to treat stones in the paediatric population [1].…”

Section: Discussionmentioning

confidence: 99%

“…These patients are therefore at high risk of recurrence [5]. Whilst historically many children underwent open, invasive procedures for the treatment of their stones, more recently endourological techniques have been favoured [6] and have been shown to be safe and effective in the management of stones, even in pre-school-aged children [7]. …”

Section: Introductionmentioning

confidence: 99%

Ureteroscopy for Paediatric Renal Tract Stones - Outcomes from a Tertiary European Centre

Chedgy

Griffin²,

Dyer³

et al. 2015

Urol Int

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Aims: The use of ureteroscopy in treating paediatric stone disease has risen in recent years. We retrospectively reviewed the results of ureteroscopic stone management for our regional paediatric stone service. Material and Methods: Between April 2010 and October 2013, consecutive patients undergoing ureteroscopy and stone fragmentation were identified. Data were recorded from electronic records for patient demographics, pre-operative assessment, stone characteristics, and intra- and post-operative complications. Results: Twenty-one patients (mean age 8.6 years; range: 1.4-16) had 32 procedures in our series (13 males and 8 females). Five (24%) had a metabolic abnormality and 8 (38%) had an anatomical abnormality. The mean initial stone size was 9.6 mm (range: 5-20) and 10 were left sided. Of the 32 procedures, 18 (56%) had a pre-operative stent. A positive pre-operative urine culture was seen in 4 (13%). CT was used in 6 (19%) with the rest having a combination of USS and/or plain KUB. Of these 21 patients, 13 (62%) were stone free after the first procedure, 17 (81%) after a second and 20 (95%) after a third (mean 1.5 procedures/patient). One patient with a 6-mm residual fragment chose to have surveillance. Eighteen (50%) had post-operative stent insertion. The mean length of stay was 1.5 days (range: 0-5). A minor complication (Clavien 1) was observed in 1 patient. No other complications were recorded. Conclusions: Ureteroscopy for stone disease in children is feasible with a low complication rate and high stone-free rate.

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“…Today PCNL is used either as a monotherapy or in combination with shockwave lithotripsy SWL (sandwich therapy) in children to achieve stone-free rates ranging from 68% to 100%. 1,2 Although there is no current international consensus, relative indications for PCNL as a primary treatment modality in children include large upper tract stone burden (>1.5 cm), lower pole calculi larger than 1 cm, concurrent anatomic abnormality impairing urinary drainage and stone clearance, or known cystine or struvite composition. 3 We report on a child with a retained Double J (DJ) ureteral stent with both renal and bladder calculi treated with PCNL and PCCL (percutaneous cystolithotripsy) in a single sitting.…”

Section: Introductionmentioning

confidence: 99%

Retained Double J Stent with Huge Renal and Bladder Calculi Extracted by Percutaneous Nephrolithotomy and Percutaneous Cystolitholapaxy in a Single Encounter

NerliRajendra

PatilShivagouda

MagdumPrasad

et al. 2017

Journal of Endourology Case Reports

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What changed in the management of pediatric stones after the introduction of minimally invasive procedures? A single-center experience over 24 years

Cited by 40 publications

References 8 publications

The application of S.T.O.N.E. nephrolithometry in pediatric patients with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy

The application of S.T.O.N.E. nephrolithometry in pediatric patients with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy

Ureteroscopy for Paediatric Renal Tract Stones - Outcomes from a Tertiary European Centre

Retained Double J Stent with Huge Renal and Bladder Calculi Extracted by Percutaneous Nephrolithotomy and Percutaneous Cystolitholapaxy in a Single Encounter

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