1
|
Gupta CR, Khan NA, Sengar M, Mohta A. Laparoscopic Surgery in Pediatric Upper Tract Urolithiasis: An Alternate Modality. J Indian Assoc Pediatr Surg 2021; 26:401-403. [PMID: 34912136 PMCID: PMC8637995 DOI: 10.4103/jiaps.jiaps_233_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/10/2020] [Accepted: 03/08/2021] [Indexed: 11/04/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Chhabi Ranu Gupta
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Niyaz Ahmed Khan
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Mamta Sengar
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Anup Mohta
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, New Delhi, India
| |
Collapse
|
2
|
Qiu Z, Guo QB, Ablikim Z, Shi XW, Hou JJ, Chen C, Hasanjan M, Akbarjan M, Anwar A. Safety and efficacy of ultrasound-guided low-pressure perfusion mini-percutaneous nephrolithotomy in children aged 1-7 years: a retrospective observational study. Int Urol Nephrol 2021; 53:1969-1976. [PMID: 34216340 DOI: 10.1007/s11255-021-02933-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This article analyzed the safety and efficacy of ultrasound-guided mini-percutaneous nephrolithotomy (MPCNL) with low-pressure perfusion for the treatment of upper urinary tract stones in children. METHODS The clinical data of 690 patients (805 renal units) aged 1-7 years were retrospectively analyzed in terms of postoperative outcome. RESULTS The mean patient age was 3.7 ± 1.6 years, and the stone burden was 2.8 ± 2.1 cm2. A middle posterior calyceal puncture was created in 719 (89%) renal units, and 16F puncture tracts were the most common method used in 557 (69%) renal units. The stone-free rate was 711 (88%) renal units, and the mean operation time was 35 ± 15.3 min (between 15 and 110 min). Among all cases, the transfusion rate was 4 (0.6%) patients, and the mean decrease in hemoglobin was 1.3 ± 0.9 g/L. In addition, the incidence rates of fever, sepsis, perirenal effusion, and intraperitoneal effusion were 40 (5.9%), 3 (0.4%), 28 (4.1%), and 8 (1.2%) patients, respectively. After the operation, 348 patients were followed-up for 32.8 ± 11.3 months, and stone recurrence occurred in 136 (39%) of 348 patients. CONCLUSIONS This study suggests that ultrasound-guided MPCNL with low-pressure perfusion technology is a safe and feasible treatment.
Collapse
Affiliation(s)
- Zhi Qiu
- Department of Urology, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China. .,Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China.
| | - Quan-Bin Guo
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Zakir Ablikim
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Xu-Wen Shi
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Jiang-Jiang Hou
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Chang Chen
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Mamat Hasanjan
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Mamat Akbarjan
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| | - Abdukadir Anwar
- Department of Urology, Hotan People's Hospital, Hotan, 848000, Xinjiang Uyghur Autonomous Region, China
| |
Collapse
|