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Fragoso AC, Steyaert H, Arnaud P, et al. Minimal access surgery in the management of pediatric urolithiasis. Transl Pediatr. 2016;5(4):262-265doi: 10.21037/tp.2016.09.09.
Fragoso, A. C., Steyaert, H., Arnaud, P., Esposito, C., Estevao-Costa, J., & Valla, J. S. (2016). Minimal access surgery in the management of pediatric urolithiasis. Translational pediatrics, 5(4), 262-265. https://doi.org/10.21037/tp.2016.09.09
Fragoso, Ana Catarina, et al. "Minimal access surgery in the management of pediatric urolithiasis." Translational pediatrics vol. 5,4 (2016): 262-265. doi: https://doi.org/10.21037/tp.2016.09.09
Fragoso AC, Steyaert H, Arnaud P, Esposito C, Estevao-Costa J, Valla JS. Minimal access surgery in the management of pediatric urolithiasis. Transl Pediatr. 2016 Oct;5(4):262-265. doi: 10.21037/tp.2016.09.09. PMID: 27867850; PMCID: PMC5107375.
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Transl Pediatr. 2016 Oct;5(4):262-265. doi: 10.21037/tp.2016.09.09.

Minimal access surgery in the management of pediatric urolithiasis.

Translational pediatrics

Ana Catarina Fragoso, Henry Steyaert, Pierre Arnaud, Ciro Esposito, Jose Estevao-Costa, Jean-Stephane Valla

Affiliations

  1. Department of Pediatric Surgery, Faculty of Medicine of Porto, Hospital S. Joa˜o, 4200-319 Porto, Portugal.
  2. Department of Pediatric Surgery, Hospital Lenval, Nice, France.
  3. Department of Pediatrics, Pediatric Surgery, ''Frederico II'' University of Naples, School of Medicine, Naples, Italy.

PMID: 27867850 PMCID: PMC5107375 DOI: 10.21037/tp.2016.09.09

Abstract

BACKGROUND: In contrast to adult patients, a relatively large number of open surgical procedures are still needed in the treatment of urolithiasis in children. Since almost all open surgical techniques may be reproduced by minimal access surgery (MAS), there is a rationale to apply the latter in the management of pediatric urolithiasis. Our study aimed to assess the feasibility and outcome of MAS in the treatment of pediatric urinary calculi.

METHODS: The charts of patients with urolithiasis submitted to MAS between 1994 and 2007 were retrospectively reviewed. The inclusion criteria were contraindication for and failure of lithotripsy or endourology techniques. Demographic data, lithiasis characterization (location, dimension, composition), predisposing factors (anatomic or metabolic) and surgical approach (technique and outcome) were evaluated.

RESULTS: Fifteen consecutive patients (eight girls, seven boys) with a median age of 108 months (range: 10-297 months) were elected for MAS. Eleven (73%) children had associated urogenital malformations and three (20%) presented metabolic abnormalities. A total of 17 procedures were performed laparoscopically: three nephrolithotomy (one transperitoneal, two by retroperitoneoscopy), four pyelolithotomies (retro), three ureterolithotomy (trans) and seven cystolithotomies (suprapubic approach). Five patients underwent concomitant correction of urological anomalies (three calyceal diverticula, one obstructive megaureter, one ureteropelvic junction obstruction). Complete removal of calculi was accomplished in 14 (82%) procedures. There were two perioperative complications (one intraperitoneal vesical perforation and one perivesical urinoma). At a median follow up of 4 years (range, 1 month to 11 years), four patients have developed recurrence.

CONCLUSIONS: MAS is an effective and safe approach for urolithiasis in children who are not candidates for minimally invasive modalities.

Keywords: Minimal access surgery (MAS); pediatric urolithiasis

Conflict of interest statement

The authors have no conflicts of interest to declare.

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