الفهرس 
? Anatomy of the KidneyOnly 14 pages are availabe for public view
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Abstract
BACKGROUND: Renal stone disease is a significant medical problem. Extra-corporeal shockwave lithotripsy is considered the first-line for treatment of pediatric urolithiasis. Percutaneous nephrolithotomy consider one of the minimally invasive treatment strategies.
AIM OF WORK: to evaluate& compare the results of mini-percutaneous nephrolithotomy vs. extracorporeal shock wave lithotripsy in management of pediatric renal stones as regards effectiveness, safety, the need for retreatment and any complication of both approaches.
PATIENTS & METHODS: A total of 54 pediatric patients with renal stones were included in our study over the period from August 2013 and July 2016 in Urology department of Ain Shams University Hospital. Patients were divided into two groups. group A (n=27) were managed by mini-percutaneous nephrolithotomy surgery while group B (n=27) were managed by extracorporeal shock wave lithotripsy. Patients’ age ranged from 2 to 12 years. All patients were presented with renal stones. Patients were followed up for three months and results were recorded and compared.
RESULTS: Stone-free rates in the mini-PCNL and ESWL groups were 88.90% versus 55.60% (P = 0.006) and 92.59% versus 88.89% (P = 0.639) after first and last sessions, respectively. In the renal pelvis groups, they were 85.0% versus 61.9% (P = 0.095) and 90.0% versus 90.5% (P = 0.956), whereas in the lower calyceal groups, they were 100% versus 33.3% (P = 0.006) and 100% versus 83.3% (P = 0.26) after first and last sessions, respectively. Retreatment rates in the mini-PCNL versus ESWL were 3.7% versus 33.3% (P = 0.005) respectively. No significant difference was found in complications (P = 0.484) and Auxiliary procedures (P = 0.639). Mean fluoroscopy time and hospital stay in the mini-PCNL and ESWL groups were 268.89 versus 79.07 seconds (P < 0.001) and 63.70 versus 4.89 hours (P < 0.001) respectively.
CONCLUSIONS: Mini-PNL has a higher stone free than ESWL after 1st session and 3rd session with significant higher retreatment rate 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.