Burak Özçift1, Hüseyin Tuğrul Tiryaki2. 1. Health Sciences University, Izmir Dr. Behcet Uz Child Diseases and Surgery Training and Researching Hospital. Pediatric Urology Unit. Izmir. Turkey. 2. Health Sciences University. Ankara Child Health and Diseases Hematology Oncology Training and Researching Hospital. Pediatric Urology Clinic. Ankara. Turkey.
Abstract
OBJECTIVE: To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrarenal surgery (RIRS) in children with 10-20 mm renal stones. MATERIALS AND METHODS: Between 2015 and 2019, 63 pediatric patients aged under 16 years who under went mini-PNL and RIRS for the treatment of kidney stones sized 10-20 mm were analyzed retrospectively. The mini-PNL group (n=30) was defined as group 1 and the RIRS group (n=33) was defined as group 2. Peri-operative data including stone-free rate, operative time, fluoroscopy time, hospitalization time, number of anesthesia sessions, complication rates, and cost-effectiveness were analyzed. RESULTS: The mean age was 8.09±5.49 years in group 1 and 5.75±4.56 years in group 2. The stone free rate was not different at the first (80.0% vs. 57.6%) and third month (93.3% vs. 90.9%) follow-up in group 1 and group 2. The mean hospitalization, operative, and fluoroscopy times were statistically significantly longer in group 1. The mean number of anesthesia sessions for patients was 1.20±0.40 in group 1 and 2.15±0.44 in group 2 (p=0.00). Minor complication rates were not different and no major complications were observed in either group. The cost per patient was calculated as 365.97 Euros in group 1 and 698.64 Euros in group 2 (p=0.001). CONCLUSIONS: This study suggested that RIRS was an effective alternative treatment method for 10-20 mm kidney stones in children, with comparable stone-free and complication rates. RIRS has a shorter operative time, fluoroscopy time, hospital stay than mini-PNL, with a similar stone-free rate for 10-20 mm kidney stones in children. However, mini-PNL is cheaper and allowed a lower need for anesthesia sessions.
OBJECTIVE: To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrarenal surgery (RIRS) in children with 10-20 mm renal stones. MATERIALS AND METHODS: Between 2015 and 2019, 63 pediatric patients aged under 16 years who under went mini-PNL and RIRS for the treatment of kidney stones sized 10-20 mm were analyzed retrospectively. The mini-PNL group (n=30) was defined as group 1 and the RIRS group (n=33) was defined as group 2. Peri-operative data including stone-free rate, operative time, fluoroscopy time, hospitalization time, number of anesthesia sessions, complication rates, and cost-effectiveness were analyzed. RESULTS: The mean age was 8.09±5.49 years in group 1 and 5.75±4.56 years in group 2. The stone free rate was not different at the first (80.0% vs. 57.6%) and third month (93.3% vs. 90.9%) follow-up in group 1 and group 2. The mean hospitalization, operative, and fluoroscopy times were statistically significantly longer in group 1. The mean number of anesthesia sessions for patients was 1.20±0.40 in group 1 and 2.15±0.44 in group 2 (p=0.00). Minor complication rates were not different and no major complications were observed in either group. The cost per patient was calculated as 365.97 Euros in group 1 and 698.64 Euros in group 2 (p=0.001). CONCLUSIONS: This study suggested that RIRS was an effective alternative treatment method for 10-20 mm kidney stones in children, with comparable stone-free and complication rates. RIRS has a shorter operative time, fluoroscopy time, hospital stay than mini-PNL, with a similar stone-free rate for 10-20 mm kidney stones in children. However, mini-PNL is cheaper and allowed a lower need for anesthesia sessions.