title: Management of stone disease in infants.
abstract: Evaluating and treating renal stone disease in infants are technically challenging. In this study, we evaluated the surgical treatment of renal stones in children under 1 year of age. We retrospectively reviewed the records of patients under 1 year old who were treated with ESWL, endourological or open surgical procedures for renal stone disease between January, 2009 and December, 2012. The patients' age, gender, stone size, stone location and number, complications, stone-free status, and postoperative complications were recorded. 19 of 121 infants with a mean age of 10.2 ± 3.07 months were treated with surgical procedures. Six (75%) of eight cystinuria patients required a surgical intervention. Retrograde endoscopic management was performed in thirteen patients (63.4%) as an initial surgical approach. There were three major (15.7%) complications. The rate of open surgical procedures was 31.6% (6 of 19 infants). The cutoff value of stone size for open surgery was 10 mm. There was a significant relationship between the conversion to open procedures and stone size, stone location, and symptom presentation especially the presence of obstruction (p < 0.05). After repeated treatments, the stone clearance rate of RIRS reached 84.6%. Retrograde intrarenal surgery is an effective and safe treatment method for renal stones in infants and can be used as a first-line therapy in most patients under 1 year old. This is especially important if an associated ureteral stone or lower pole stone that requires treatment is present and for patients with cystinuria, which does not respond favorably to ESWL.
authors.affiliation: Department of Pediatric Surgery, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, No:10 Diskapi, 06110, Ankara, Turkey. drmujdemazili@yahoo.com.
authors.forename: Mujdem Nur
authors.initials: MN
authors.lastname: Azili
authors.affiliation: Department of Pediatric Surgery, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, No:10 Diskapi, 06110, Ankara, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozturk
authors.affiliation: Department of Pediatric Nephrology, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Mihriban
authors.initials: M
authors.lastname: Inozu
authors.affiliation: Department of Pediatric Nephrology, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Fatma Şemsa
authors.initials: FŞ
authors.lastname: Çayci
authors.affiliation: Department of Pediatric Nephrology, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Acar
authors.affiliation: Department of Anesthesiology, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Sengul
authors.initials: S
authors.lastname: Ozmert
authors.affiliation: Department of Pediatric Urology, Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Tugrul
authors.initials: T
authors.lastname: Tiryaki
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy; D008297:Male; D012189:Retrospective Studies; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*
keywords: Endourology; Infant; Nephrolithiasis; Surgical treatment