Urolithiasis in Children: Etiopathogenesis of Kidney Stone Disease and Extracorporeal Shockwave Lithotripsy
SP Yatzik1,2and AA Gusev1,3*
1Research Institute of Pediatric Surgery of Federal State Autonomous Institution “National Medical Research
Center for Children's Health” of the Ministry of Health of the Russian Federation, Russia
2Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Russia
3RUDN University (Peoples Friendship University of Russia); Moscow, Russia
*Corresponding Author: AA Gusev, Research Institute of Pediatric Surgery of Federal State Autonomous Institution “National Medical Research Center for Children's Health” of the Ministry of Health of the Russian Federation, Russia.
October 13, 2021; Published: November 11, 2021
The fact that urolithiasis becomes more common among infants is frustrating . Bilateral process is observed in 15-30% of patients according to the literature. Kidney stone disease (KSD, also known as urolithiasis) is a pretty tricky disease, apart from its high incidence it has a tendency to recurrence. Such patients usually have severe course of disease, development of serious complications, that in turn can lead to chronic renal failure (CRF).
Nowadays laparoscopy and retroperitoneoscopy are rarely used for removal of calculi from kidneys and ureters. Such combined methods as percutaneous lithocenosis with ureterorenoscopy (endoscopic combined intrarenal surgery (ECIRS)) are used more often. This procedure involves less postoperative complications, reduces hospital stay and recovery time, improves cosmetic results and would not disgrace the traditional surgery in functional results, if compared with open surgery methods for calculi extraction . The number of open surgeries has significantly reduced, it can be used as the last method when all other minimally invasive procedures have no positive effect.
Both transurethral and percutaneous endoscopic lithotripsy should not be opposed to extracorporeal shockwave lithotripsy (ESWL) because these methods complement each other in 18-27% of cases. Whereas endoscopic surgeries allow not only to remove the calculus, but also to eliminate simultaneously the cause of lithogenesis (internal urethrotomy, ureterocele dissection, ligature removal, etc.) .
The extracorporeal lithotripsy is currently the least invasive method of calculus removal. Such factors as calculus density and composition would be important in choosing the treatment method.
Keywords: Kidney Stone Disease; Chronic Renal Failure; Extracorporeal Shockwave Lithotripsy; Etiopathogenetic Principles; Calculus Removal
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