Outcomes and lessons learnt from practice of retrograde intrarenal surgery (RIRS) in a paediatric setting of various age groups: a global study across 8 centres

Lim E. J., Traxer O., Quiroz Madarriaga Y., Castellani D., Fong K. Y., Chan V. W., ...Daha Fazla

WORLD JOURNAL OF UROLOGY, cilt.40, sa.5, ss.1223-1229, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 40 Sayı: 5
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s00345-022-03950-3
  • Dergi Adı: WORLD JOURNAL OF UROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, EMBASE, Gender Studies Database, MEDLINE
  • Sayfa Sayıları: ss.1223-1229
  • Anahtar Kelimeler: Paediatric, Renal stone, Retrograde intrarenal surgery, Ureteroscopy, Renal calculi, STONE DISEASE, URETEROSCOPY, ACCESS
  • Marmara Üniversitesi Adresli: Evet

Özet

Purpose To analyse and report the practice, outcomes and lessons learnt from a global series of retrograde intrarenal surgery (RIRS) in a paediatric multicentre series. Methods A retrospective review of anonymized pooled data gathered globally from 8 centres in paediatric patients (<= 18 years of age) who had renal stones and underwent RIRS from 2015 to 2020 was performed. Patient demographics, perioperative parameters, stone characteristics, complications and stone-free rate (SFR; defined as endoscopically stone free and/or residual fragments < 2 mm on follow up imaging) were analysed. The cohort was stratified into 3 groups by age: < 5 years (Group A), 5-10 years (Group B) and > 10 years (Group C). Overall, post-operative complication rate was 13.7%. Chi-square comparisons were used for categorical variables; analysis of variance (ANOVA) or Kruskal-Wallis tests were used for continuous variables. Results 314 patients were analysed. The mean age was 9.54 +/- 4.76 years. Groups A, B and C had 67 (21.3%), 83 (26.4%) and 164 (52.2%) patients, respectively. Mean stone size was 10.7 +/- 4.62 mm. Pre-stenting was performed in 155 (49.4%) of patients, ureteral access sheaths (UAS) was used in 54.5% of patients with majority (71%) utilizing holmium laser for stone fragmentation. All complications were minor (Clavien-Dindo grade 1 and 2). SFR was 75.5%. Conclusions RIRS is acceptable as a first-line intervention in the paediatric population with reasonable efficacy and low morbidity. Complications are slightly higher in patients < 5 years of age, which should be taken into account while counselling patients.