Dogan HS et al, 2012: Minimally invasive surgical approaches to kidney stones in children
Dogan HS, Tekgul S
Department of Urology, Uludag University, Faculty of Medicine, 16059, Bursa, Turkey
The existing treatment options for pediatric urolithiasis are endoscopic methods. Extracorporeal shockwave lithotripsy (SWL) is the first-line option for most of the kidney stones smaller than 1 cm in diameter. For larger stones or refractory cases, minimally invasive surgical methods are preferred. Percutaneous nephrolithotomy (PCNL) is a well-established treatment modality for most patients. This technique has shown evolution also in children so that miniaturized or tubeless methods could now be performed. Recent series show that flexible ureteroscopy is also becoming an important treatment option in the pediatric urology armamentarium for treating the calyceal and lower pole stones. Open surgery has a very limited role and it may be of use when there is a need to do an adjuvant reconstructive surgery. With the increasing experience, laparoscopic surgery is becoming an alternative option that may have potential to replace the open techniques.
Curr Urol Rep. 2012 Aug;13(4):298-306. doi: 10.1007/s11934-012-0259-8
PMID: 22717737 [PubMed - in process]
This is just a review of available treatment options for active removal of stone from the urinary tract in children. It is stated that ESWL is the first line option at least for stones with a diameter up to 10 mm. Other methods such as PNL with small size instruments, RIRS and also laparoscopic surgery are discussed. There is essentially no new information in this review.