MODERN APPROACHES TO SURGICAL TREATMENT OF NEPHROLITHIASIS IN CHILDREN: LITERATURE REVIEW

Pediatric nephrolithiasis has experienced a dramatic increase in incidence over the past two decades, prompting evolution from open surgical approaches to minimally invasive techniques. This review examines current operative methods for treating upper urinary tract calculi in children, emphasizing the principles of radiation protection (ALARA), preservation of renal function, and minimization of anesthetic exposure. We analyze advances in miniaturized percutaneous nephrolithotomy including super-mini PCNL (10-14F), developments in flexible ureteroscopy with modern laser technologies including thulium fiber laser, and the role of ultrasound-guided procedures. Current treatment algorithms based on stone size, location, and patient characteristics demonstrate that miniaturized endoscopic techniques offer superior stone-free rates with acceptable safety profiles. The evidence supports personalized approaches incorporating family preferences while achieving optimal clinical outcomes.