What is the best approach for pediatric kidney stones of moderate-sized between shock wave lithotripsy, ultramini percutaneous nephrolithotomy and retrograde intrarenal surgery?
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In brief
In brief
Comparative study of three surgical approaches for moderate-sized pediatric kidney stones (10-20mm) shows ultramini percutaneous nephrolithotomy and retrograde intrarenal surgery achieve superior stone-free rates compared to shock wave lithotripsy, with UMP demonstrating particular advantage for lower pole stones. All three methods showed comparable safety profiles.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study aimed to compare the results of ultramini percutaneous nephrolithotomy (UMP), shock wave lithotripsy (SWL) and retrograde intrarenal surgery (RIRS) in pediatric patients with kidney stones 10–20 mm size.
Methods
The files of 159 pediatric patients (36 RIRS, 39 SWL, 84 UMP) with kidney stones were reviewed retrospectively. Preoperative age, sex, stone size and location were evaluated. The three methods were compared in terms of operation and fluoroscopy duration, complications with the modified Clavien grading system, and stone-free rate (SFR) in the postoperative first month.
Results
The stone burdens of the groups were similar (P = 0.102). At the end of the first month, SFR was higher in the RIRS and UMP groups compared to the SWL group (88.9%, 92.9% and 69.2%, respectively, P = 0.002). UMP had higher SFR for lower pole stones than the other two methods (P = 0.042). There was no difference in complications between the three methods (P = 0.758).
Conclusion
SFR was similar for all three methods in all localizations, apart from lower pole stones. UMP had higher SFR for lower pole stones than the other two methods. There was no difference in terms of complications between the three methods.