Skip to main content
SpringerLink
Log in

Is laparoscopic pyelolithotomy an alternative to percutaneous nephrolithotomy for treatment of kidney stones larger than 2.5 cm in pediatric patients?

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

The aim was to compare laparoscopic pyelolithotomy and percutaneous nephrolithotomy in terms of efficacy and safety for the treatment of renal pelvis stones larger than 2.5 cm in pediatric patients.

Methods

Our study consisted of two groups. Group 1 included 33 patients who underwent laparoscopic pyelolithotomy (LPL) between January 2013 and March 2022, and group 2 included 39 patients who underwent percutaneous nephrolithotomy (PCNL). The basic clinical parameters of the patients were recorded. Mean operation time, stone size, estimated blood loss, blood transfusion rate, postoperative hospital stay, stone-free rate, postoperative analgesia requirements, intraoperative complications, and early and late postoperative complications were compared between the two groups.

Results

In our study, the mean age of the patients in groups 1 and 2 was 8.89 ± 1.58 years and 9.1 ± 1.85 years, respectively (p = 0.657). The mean stone size was 2.37 ± 0.38 cm in group 1 and 2.55 ± 0.45 cm in group 2 (p = 0.64). The mean operation time was 85.65 ± 20.55 min in group 1, while it was 76.11 ± 13.12 min in group 2 (p = 0.08). The stone-free rate was 100% in both groups. Intraoperative mean blood loss, need for postoperative analgesia, blood transfusion and intraoperative complication rates were significantly higher in the PCNL group (p < 0.01, p = 0.02, p < 0.01, p < 0.01, respectively).

Conclusion

Our results show that laparoscopic pyelolithotomy is a safe and effective method for pediatric patients with large kidney stones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. VanDervoort K, Wiesen J, Frank R, Vento S, Crosby V, Chandra M, Trachtman H (2007) Urolithiasis in pediatric patients: a single center study of incidence, clinical presentation and outcome. J Urol 177(6):2300–2305. https://doi.org/10.1016/j.juro.2007.02.002

    Article  PubMed  Google Scholar 

  2. Rizvi SA, Sultan S, Ijaz H, Mirza ZN, Ahmed B, Saulat S, Naqvi SA (2010) Open surgical management of pediatric urolithiasis: a developing country perspective. Indian J Urol 26(4):573. https://doi.org/10.4103/0970-1591.74464

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hwang K, Mason M, Peters C (2011) Clinical practice: surgical approaches to urolithiasis in children. Eur J Pediatr 170(6):681–688. https://doi.org/10.1007/s00431-010-1373-6

    Article  PubMed  Google Scholar 

  4. Landau E (2015) Modern stone management in children. Eur Urol Suppl 14(1):12–19. https://doi.org/10.1016/j.eursup.2015.01.004

    Article  Google Scholar 

  5. Casale P, Grady R, Joyner B, Zeltser I, Kuo R, Mitchell M (2004) Transperitoneal laparoscopic pyelolithotomy after failed percutaneous access in the pediatric patient. J Urol 172:680–683. https://doi.org/10.1097/01.ju.0000129462.23322.e0

    Article  PubMed  Google Scholar 

  6. Micali S, Moore RG, Averch TD, Adams JB, Kavoussi LR (1997) The role of laparoscopy in the treatment of renal and ureteral calculi. J Urol 157(2):463–466. https://doi.org/10.1016/S0022-5347(01)65173-5

    Article  CAS  PubMed  Google Scholar 

  7. Goel A, Hemal AK (2003) Evaluation of role of retroperitoneoscopic pyelolithotomy and its comparison with percutaneous nephrolithotripsy. Int Urol Nephrol 35(1):73–76. https://doi.org/10.1023/A:1025962009286

    Article  PubMed  Google Scholar 

  8. Passerotti C, Nguyen H, Retik A, Peters C (2008) Patterns and predictors of laparoscopic complications in pediatric urology: the role of ongoing surgical volume and access techniques. J Urol 180:681–685. https://doi.org/10.1016/j.juro.2008.04.042

    Article  PubMed  Google Scholar 

  9. Desai M (2005) Endoscopic management of stones in children. Curr Opin Urol 15:107–112. https://doi.org/10.1097/01.mou.0000160625.59107.fd

    Article  PubMed  Google Scholar 

  10. Sarica K (2006) Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment. Urol Res 34:96–101. https://doi.org/10.1007/s00240-005-0018-0

    Article  CAS  PubMed  Google Scholar 

  11. Djelloul Z, Djelloul A, Bedjaoui A, Kaid-Omar Z, Attar A, Daudon M, Addou A (2006) Urinary stones in Western Algeria: study of the composition of 1,354 urinary stones in relation to their anatomical site and the age and gender of the patients. Prog Urol 16(3):328–335

    PubMed  Google Scholar 

  12. Straub M, Gschwend J, Zorn C (2010) Pediatric urolithiasis: the current surgical management. Pediatr Nephrol 25:1239–1244. https://doi.org/10.1007/s00467-009-1394-4

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tekgül S, Stein R, Bogaert G, Nijman RJ, Quaedackers J, Silay MS, Doğan HS (2021) European association of urology and European society for paediatric urology guidelines on paediatric urinary stone disease. Eur Urol Focus. https://doi.org/10.1016/j.euf.2021.05.006

    Article  PubMed  Google Scholar 

  14. Schneck FX, Ost MC (2016) Surgical management of pediatric stone disease. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA (eds) Campbell-Walsh urology, 11th edn. Elsevier, Philadelphia, pp 3102–3120

    Google Scholar 

  15. Unsal A, Resorlu B, Kara C, Bozkurt OF, Ozyuvali E (2010) Safety and efficacy of percutaneous nephrolithotomy in infants, preschool age, and older children with different sizes of instruments. Urology 76(1):247–252. https://doi.org/10.1016/j.urology.2009.08.087

    Article  PubMed  Google Scholar 

  16. Jackman SV, Hedican SP, Peters CA, Docimo SG (1998) Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 52(4):697–701. https://doi.org/10.1016/S0090-4295(98)00315-X

    Article  CAS  PubMed  Google Scholar 

  17. Soltani MH, Simforoosh N, Nouralizadeh A, Sotoudeh M, Mollakoochakian MJ, Shemshaki HR (2016) Laparoscopic pyelolithotomy in children less than two years old with large renal stones: Initial series. Urol J 13:2837–2840. https://doi.org/10.22037/uj.v13i5.3553

    Article  PubMed  Google Scholar 

  18. Agrawal V, Bajaj J, Acharya H, Chanchalani R, Raina VK, Sharma D (2013) Laparoscopic management of pediatric renal and ureteric stones. J Pediatr Urol 9:230–233. https://doi.org/10.1016/j.jpurol.2012.03.001

    Article  PubMed  Google Scholar 

  19. Cezarino BN, Park R, Moscardi PR, Lopes RI, Denes FT, Srougi M (2016) Retroperitoneoscopic pyelolithotomy: a good alternative treatment for renal pelvic calculi in children. Int Braz J Urol 42:1248. https://doi.org/10.1590/S1677-5538.IBJU.2015.0242

    Article  PubMed  PubMed Central  Google Scholar 

  20. Gaur DD, Trivedi S, Prabhudesai MR, Madhusudhana HR, Gopichand M (2002) Laparoscopic ureterolithotomy: technical considerations and long-term follow-up. BJU Int 89:339–343. https://doi.org/10.1046/j.1464-4096.2001.01562.x

    Article  CAS  PubMed  Google Scholar 

  21. Landa-Juárez S, Rivera-Pereira BM, Castillo-Fernández AM (2018) Management of pediatric urolithiasis using a combination of laparoscopic lithotomy and pyeloscopy. J Laparoendosc Adv Surg Tech A 28:766–769. https://doi.org/10.1089/lap.2016.0652

    Article  PubMed  Google Scholar 

  22. Jordan GH, McCammon KA, Robey EL (1997) Laparoscopic pyelolithotomy. Urology 49:131–134. https://doi.org/10.1016/S0090-4295(96)00363-9

    Article  CAS  PubMed  Google Scholar 

  23. Al-Hunayan A, Abdulhalim H, El-Bakry E, Hassabo M, Kehinde EO (2009) Laparoscopic pyelolithotomy: Is the retroperitoneal route a better approach? Int J Urol 16:181–186. https://doi.org/10.1111/j.1442-2042.2008.02210.x

    Article  PubMed  Google Scholar 

  24. Valla JS (2007) Retroperitoneoscopic surgery in children. Semin Pediatr Surg 16:270–277. https://doi.org/10.1053/j.sempedsurg.2007.06.010

    Article  PubMed  Google Scholar 

  25. Haggag YM, Morsy G, Badr MM, Al Emam ABA, Farid M, Etafy M (2013) Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones. Can Urol Assoc J 7(3–4):E171. https://doi.org/10.5489/cuaj.490

    Article  PubMed  PubMed Central  Google Scholar 

  26. Meria P, Milcent S, Desgrandchamps F, Mongiat-Artus P, Duclos JM, Teillac P (2005) Management of pelvic stones larger than 20 mm: laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy? Urol Int 75(4):322–326. https://doi.org/10.1159/000089167

    Article  PubMed  Google Scholar 

  27. Honeck P, Wendt-Nordahl G, Krombach P, Bach T, Häcker A, Alken P, Michel MS (2009) Does open stone surgery still play a role in the treatment of urolithiasis? Data of a primary urolithiasis center. J Endourol 23(7):1209–1212. https://doi.org/10.1089/end.2009.0027

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Sciences University, Adana City Training and Research Hospital Urology Clinic, Adana, Turkey

    Hakan Erçil, Kadir Karkin & Ediz Vuruşkan

Authors
  1. Hakan Erçil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kadir Karkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ediz Vuruşkan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

K.K., H.E. and EV wrote the main manuscript text and K.K. prepared tables 1 and 2. All the authors reviewed the manuscript.

Corresponding author

Correspondence to Hakan Erçil.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Erçil, H., Karkin, K. & Vuruşkan, E. Is laparoscopic pyelolithotomy an alternative to percutaneous nephrolithotomy for treatment of kidney stones larger than 2.5 cm in pediatric patients?. Pediatr Surg Int 39, 78 (2023). https://doi.org/10.1007/s00383-023-05367-4

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00383-023-05367-4

Keywords

Search

Navigation