Nephro-urology interventions in children.
Nephro-urological interventions developed in adult practice are highly transferable to the pediatric setting, and their use has widened the role of interventional radiology in the management of renal tract pathology in spheres such as oncology and urolithiasis. The emerging evidence is that these procedures are safe and effective in children and their use should be encouraged. Many of the techniques are similar to those used in adults. There are, however, subtle but important pediatric tips and tricks available that serve to minimize risk to the child and increase the chances of technical success. This article covers the indications, techniques, aftercare, and complications for renal biopsy, nephrostomy insertion, percutaneous nephrolithomy procedures, and ureteric stent insertion. Renal biopsy and nephrostomy insertion are commonly performed in most pediatric centers. Percutaneous nephrolithomy may be limited to centers with a significant urology workload, but are complex procedures ideally performed as joint cases between urology and interventional radiology.
Department of Radiology, Great Ormond Street Hospital, London, UK. barnaa@gosh.nhs.uk
Alex M
AM
Barnacle
Derek J
DJ
Roebuck
John M
JM
Racadio
D000293:Adolescent; D001706:Biopsy; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009398:Nephrology / Q000295:instrumentation / Q000379:methods*; D009403:Nephrostomy, Percutaneous; D015641:Radiography, Interventional / Q000009:adverse effects / Q000295:instrumentation; D015607:Stents; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000295:instrumentation; D014572:Urology / Q000295:instrumentation / Q000379:methods*