ESWL and PCNL management of pediatric renal calculi / 中华泌尿外科杂志

ABSTRACT

Objective To summarize the experience of ES WL and PCNL management for pediatric renal calculi. Methods We retrospectively reviewed the clinical data 105 cases.The series consists of 33 girls and 72 boys.The average age was 8.7 years.Of the 105 children,21(20. 0%) had urinarytract abnormality.68 cases were treated with ESWL,33 with mini-P CNL,and 4 cases with residual stone fragments were treated with min-PCNL and ES WL.Four children underwent open procedures. Results 92 s essions of ESWL were performed in 68 children,57(83.8%)became stone-free.Among them 47 cases ( 69.1 %) were cured by one ESWL session,18 cases(26.5%)had two sessions,three children had three sessions.Two cases who had ureteral steinstras se were rendered stone-free by ureteroscopy.Among 33 children managed by mini- PCNL,24 (72.7%) were cured by one PCNL session,9(27.3%) by two sessions,three pa tients with UPJ obstruction underwent antegrade pyeloureterotomy at the same tim e.Stones were cleared using one PCNL session in 24(72.7%),2 sessions in 29(87.9% ),4 patients were cured with ESWL and mini-PCNL.The overall success rate was 97 .0%.2 of 4 cases in open procedures were performed by means of pyeloplasty,one p atient had residual stone fragments after open surgery. Conclusions ESWL is the first-line treatment for renal calculi in children.PCN L is a option but based on stones status,instrumental and technical conditions. Combining PCNL with ESWL had better outcome.