Image not available

Onal B et al, 2013: What changed in the management of pediatric stones after the introduction of minimally invasive procedures? A single-center experience over 24 years

Onal B, Citgez S, Tansu N, Emin G, Demirkesen O, Talat Z, Yalcin V, Erozenci A
Department of Urology, University of Istanbul, Cerrahpasa Medical Faculty, Istanbul, Turkey


Abstract

OBJECTIVE: To assess the impact of new technology on the management of pediatric urolithiasis by analyzing our local practice over the past 24 years, and determining the role of open surgery at the present time.

METHODS: We retrospectively reviewed the charts of 768 children (783 procedures) who underwent surgical treatment for urolithiasis between June 1987 and October 2010. Data were analyzed with respect to patient characteristics and changing patterns of treatment with time. We compared the type of procedures performed between four time periods: the first was before ESWL, the second was after the introduction of ESWL, the third was after introduction of PCNL, and the fourth was our experienced period with a pediatric urologist.

RESULTS: The mean age of the children was 7.50 years (range 9 months - 17 years). There were 495 renal, 228 ureteral, 21 bladder, 11 urethral stones, and the remaining 13 had stones in multiple locations. Of the 783 procedures performed, 75.9% were open surgery during the first period (1987-1992), 29.7% during the second period (1993-1998), 6.1% during the third period (1999-2004) and 0.2% during the fourth period (2005-2010). The number of children who underwent urinary stone treatment increased significantly (p Z 0.001) and the age of the children at the time of surgery decreased (9.09-6.08 years) (p Z 0.001) with time.

CONCLUSION: The majority of stones in children can be managed using endourological procedures. Additionally, technological advances and improved surgical skills have greatly reduced the number of children requiring open surgery, which is mainly used for those with complex urinary calculi presenting with anatomic abnormalities. Minimally invasive techniques allow us to treat stones at an earlier age.

J Pediatr Urol. 2013 Jan 10. pii: S1477-5131(12)00321-X. doi: 10.1016/j.jpurol.2012.12.015. [Epub ahead of print]
PMID:23313064 [PubMed - as supplied by publisher]

Rate this blog entry:
0
 

Comments 1

Peter Alken on Monday, 13 May 2013 07:44

This is a view on the historical development of stone therapy in a single department with a large patient volume. Open surgery practically disappeared. ESWL is still the most frequently performed procedure. The data on stone free rates combine EWSL, PNL and URS. The stone-free rate for endourological procedures decreased with time.

/images/blog/OnalB2013klein.jpg

Peter Alken

This is a view on the historical development of stone therapy in a single department with a large patient volume. Open surgery practically disappeared. ESWL is still the most frequently performed procedure. The data on stone free rates combine EWSL, PNL and URS. The stone-free rate for endourological procedures decreased with time. [img]/images/blog/OnalB2013klein.jpg[/img] Peter Alken
Guest
Friday, 26 May 2017
STORZ MEDICAL AG
Lohstampfestrasse 8
8274 Tägerwilen
Switzerland
Tel.: +41 (0)71 677 45 45
Fax: +41 (0)71 677 45 05

www.storzmedical.com
Personal data
Address
Contact data
Message