MANAGEMENT OF PEDIATRIC RENAL STONES BY MINI-PERCUTANEOUS NEPHROLITHOTOMY VS. EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY A Prospective Randomized Comparative Clinical Study

Abstract

SUMMARY AND CONCLUSION T he aim of this work was to comprehensively evaluate and to compare the outcome of mini-PCNL and ESWL in management of pediatric renal stones, with regards to; stone clearance rate, safety, the need for retreatment, necessity of auxiliary procedures and any complications To achieve this purpose a total of 56 patients were included in this study between August 2013 and July 2016. All patients with single renal stones (pelvic/ lower calyceal), those with stone diameter 1- 2cm and no contraindications to perform the operation were included in this study. Our study was assigned on a randomized basis according to a 1:1 ratio and patients underwent either mini-PNL or ESWL randomly. We used blocked randomization schedule to allocate patients. After giving written consent, they were randomly divided into two groups: Group A (Included 26 patients who were treated by mini-PNL) and Group B (Included 26 patients who were treated by ESWL). All preoperative, intraoperative and postoperative parameters, results and complications between both groups were recorded. Mini-PNL has a higher stone free than ESWL after 1st session and 3rd session (significant for all patient and lower calyceal stones after 1st session). Mini-PCNL has significant lower retreatment rate than in ESWL group and without significant difference in complications and Auxiliary procedures. ESWL group has significant lower hospital stay and fluoroscopy use. Therefore, mini-PCNL should be considered in the armamentarium of clinicians who manage children with renal stones. Recurrence is a major problem as follow-up is not assured due to poor socioeconomics. Because of its recurrent nature, every effort should be made to reduce the number of procedures performed to a minimum and to save the developing kidney from the deleterious effects of the intervention.