Percutaneous Nephrolithotomy in Children (Pediatric PNL)
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Over the past several decades, there has been an increasing incidence of stone formation in children. Higher recurrence rates necessitate a multidisciplinary approach and team work for a safe and successful treatment policy. Regarding the surgical management for the removal of stones and the preservation of renal development and function, minimized radiation exposure is one of the most important factors to be considered. Complete stone clearance through experienced hands is the most important goal, and the decision needs to be individualized to the patients depending on the patient-related (age and anatomy) and stone-related (size, location, and composition) factors. At present minimal invasive management options include SWL, ureteroscopy, and PNL.
Regarding the pediatric PNL, although there is a meaningful reluctance due to the possible harmful effects of PNL on the growing kidney, PNL by using adult-sized instruments has proven itself to be safe and successful enough with comparable stone-free and complication rates. Additionally as a result of “miniaturization in PNL” concept, the use of smaller instruments has allowed the urologists to perform this procedure more commonly than ever in a safe and effective manner. The reported stone-free rates for these miniaturized techniques are 76–95% for mini, and 80–100% for the standard PNL procedures respectively.
KeywordsChildren Percutaneous nephrolithotomy Mini-PNL
- 14.Walsh DL, Jung C, Pope JC IV et al. An analysis of the efficacy of percutaneous nephrolithotomy versus extracorporeal shock wave lithotripsy for the treatment of large renal calculi in children. Presented at the American Academy of Pediatrics Section on Urology, San Francisco, CA, USA, 2007.Google Scholar