Kenneth A Softness1, Michael P Kurtz2. 1. Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA. ksoftne1@bidmc.harvard.edu. 2. Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, USA.
Abstract
PURPOSE OF REVIEW: We aim to highlight recent advances in technology and techniques for surgical management of urinary tract calculi in pediatric patients. RECENT FINDINGS: Percutaneous nephrolithotomy (PCNL) is classically performed in the prone position. The supine PCNL was first attempted to overcome the shortcomings of difficult airway access, patient and surgeon discomfort. The supine PCNL, and subsequent modifications, has been successfully described in the pediatric population. Classically, PCNL has also been classically concluded with obligate placement of a nephrostomy tube and bladder catheter. Recently, tubeless and totally tubeless PCNL reduces pain and duration of hospitalization with satisfactory surgical outcomes in children. Finally, we describe the use of thulium laser technology, which offers improved efficacy in stone treatment and may supplant the current dominant technologies in coming years. Recent advances in pediatric stone surgery include supine PCNL, miniaturized PCNL instrumentation, tubeless procedures, and thulium laser technology.
PURPOSE OF REVIEW: We aim to highlight recent advances in technology and techniques for surgical management of urinary tract calculi in pediatric patients. RECENT FINDINGS: Percutaneous nephrolithotomy (PCNL) is classically performed in the prone position. The supine PCNL was first attempted to overcome the shortcomings of difficult airway access, patient and surgeon discomfort. The supine PCNL, and subsequent modifications, has been successfully described in the pediatric population. Classically, PCNL has also been classically concluded with obligate placement of a nephrostomy tube and bladder catheter. Recently, tubeless and totally tubeless PCNL reduces pain and duration of hospitalization with satisfactory surgical outcomes in children. Finally, we describe the use of thulium laser technology, which offers improved efficacy in stone treatment and may supplant the current dominant technologies in coming years. Recent advances in pediatric stone surgery include supine PCNL, miniaturized PCNL instrumentation, tubeless procedures, and thulium laser technology.
Authors: Fabio C Vicentini; Fabio C M Torricelli; Eduardo Mazzucchi; Marcelo Hisano; Claudio B Murta; Alexandre Danilovic; Joaquim F A Claro; Miguel Srougi Journal: J Endourol Date: 2013-06-08 Impact factor: 2.942
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