Extracorporeal Shock Wave Lithotripsy Management of Renal Stones in Children: Does Anesthesia Affect the Treatment Outcomes on an Age-based Manner?

OBJECTIVE

To evaluate beneficial effect of anesthesia on extracorporeal shock wave lithotripsy (SWL) in children older than 9 years.

PATIENTS AND

METHODS

A total of 61 children (aged between 9 and 17 years) treated with SWL for renal stones were included. Depending on the use of general anesthesia, the children were divided into 2 groups: cases treated with SWL under anesthesia (group 1, n = 27) and cases treated with SWL without anesthesia (group 2, n = 34). The patients in both groups were comparatively evaluated with respect to treatment-related parameters (stone size, stone laterality, stone location, mean number of sessions, mean number of shock waves applied, residual fragments size, stone-free rate [SFR], clinically significant residual fragment complications, and need for additional intervention). The efficacy quotient was also evaluated.

RESULTS

The overall mean stone size was 10.48 ± 4.27 mm. Although there was no significant difference regarding the stone size (P = .924), stone laterality (P = .240), stone localization (P = .084), mean number of sessions (P = .392), SFR (P = .666), clinically significant residue (P = .526), size of residual fragments (P = .315), complication rates (P = 1.000), and need for additional intervention (P = 1.000), the mean number of shock waves applied was significantly higher in patients treated without anesthesia (group 2) (P = .001). The efficacy quotient was 41.7% and 35.4% for groups 1 and 2, respectively.

CONCLUSION

Our findings indicate that anesthesia-free SWL for renal stones in children aged older than 9 years is feasible and successful with similar treatment outcome data observed in cases with the same age range being treated under anesthesia. We believe that SWL without anesthesia can be applied in a safe and successful manner in relatively older and cooperative children.