Okan Baş1, Onur Dede2, Yasin Aydogmus3, Mazhar Utangaç2, Taha Numan Yikilmaz4, Erman Damar4, İsmail Nalbant1, Ömer Faruk Bozkurt4. 1. 1 Department of Urology, Diskapi Yildirim Beyazid Training and Research Hospital , Ankara, Turkey . 2. 2 Department of Urology, Faculty of Medicine, Dicle University , Diyarbakır, Turkey . 3. 3 Department of Urology, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital , Ministry of Health, Ankara, Turkey . 4. 4 Department of Urology, Urology Residency Training Program , Ankara, Turkey .
Abstract
PURPOSE: To compare the effectiveness and reliability of retrograde intrarenal surgery (RIRS) and micro-percutaneous nephrolithotomy (micro-perc) for the management of kidney stones in pediatric patients. MATERIALS AND METHODS: A retrospective analysis was made of pediatric patients aged <18 years with kidney stones that ranged from 10 to 20 mm in size, who underwent RIRS (n = 36) or micro-perc (n = 45) in referral centers. RESULTS: In the RIRS group, the mean age of patients was 8.39 ± 4.72 years and in the micro-perc group, it was 5.62 ± 4.50 years (p = 0.01). The mean stone size was 12.80 ± 3.03 mm in the RIRS group and 13.97 ± 3.46 mm in the micro-perc group (p = 0.189). The success rate was 86.2% (n = 31) in the RIRS group and 80.0% (n = 36) in the micro-perc group (p = 0.47). The mean complication rate was 16.6% and 13.3% in the RIRS and micro-perc groups, respectively (p = 0.675). Hospital stay and radiation exposure were significantly lower in the RIRS group (all p < 0.001). The mean anesthesia session was 1.94 in the RIRS group and 1.26 in the micro-perc group (p < 0.001). The mean hemoglobin drop was 0.53 ± 0.87 g/dL in the micro-perc group, and none of the cases required blood transfusion. CONCLUSION: The results of this study suggested that micro-perc and RIRS were highly effective methods for the treatment of moderately sized renal stones in children, with comparable success and complication rates. Patients and their parents should be informed about the currently available treatment options, and of their efficacy and safety. However, further clinical trials are needed to support these results.
PURPOSE: To compare the effectiveness and reliability of retrograde intrarenal surgery (RIRS) and micro-percutaneous nephrolithotomy (micro-perc) for the management of kidney stones in pediatric patients. MATERIALS AND METHODS: A retrospective analysis was made of pediatric patients aged <18 years with kidney stones that ranged from 10 to 20 mm in size, who underwent RIRS (n = 36) or micro-perc (n = 45) in referral centers. RESULTS: In the RIRS group, the mean age of patients was 8.39 ± 4.72 years and in the micro-perc group, it was 5.62 ± 4.50 years (p = 0.01). The mean stone size was 12.80 ± 3.03 mm in the RIRS group and 13.97 ± 3.46 mm in the micro-perc group (p = 0.189). The success rate was 86.2% (n = 31) in the RIRS group and 80.0% (n = 36) in the micro-perc group (p = 0.47). The mean complication rate was 16.6% and 13.3% in the RIRS and micro-perc groups, respectively (p = 0.675). Hospital stay and radiation exposure were significantly lower in the RIRS group (all p < 0.001). The mean anesthesia session was 1.94 in the RIRS group and 1.26 in the micro-perc group (p < 0.001). The mean hemoglobin drop was 0.53 ± 0.87 g/dL in the micro-perc group, and none of the cases required blood transfusion. CONCLUSION: The results of this study suggested that micro-perc and RIRS were highly effective methods for the treatment of moderately sized renal stones in children, with comparable success and complication rates. Patients and their parents should be informed about the currently available treatment options, and of their efficacy and safety. However, further clinical trials are needed to support these results.
Authors: Adam Halinski; Henri Steyaert; Magdalena Wojciech; Bartłomiej Sobolewski; Andrzej Haliński Journal: Front Pediatr Date: 2021-05-21 Impact factor: 3.418