Endoscopic combined intrarenal surgery versus percutaneuos nephrolithotomy for complex pediatric stone disease: A comparative analysis of efficacy and safety

Decision-making for complex pediatric urinary system stone disease is still a challenge for pediatric urologists. The interest in supine percutaneous nephrolithotomy (PCNL) is increasing among centers to achieve high surgical success rates with less morbidity. Despite advanced retrograde intrarenal...

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Bibliographic Details
Published in:Journal of pediatric urology 2024-08, Vol.20 (4), p.606.e1-606.e7
Main Authors: Tanidir, Yiloren, Sekerci, Cagri Akin, Genc, Yunus Emre, Gokmen, Ersin, Arslan, Faruk, Yucel, Selcuk, Tarcan, Tufan, Cam, Kamil
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Children
Complication
ECIRS
Female
Humans
Kidney Calculi - surgery
Kidney stone
Male
Nephrolithotomy, Percutaneous - adverse effects
Nephrolithotomy, Percutaneous - methods
PCNL
Retrospective Studies
Stone free rate
Treatment Outcome
Ureteroscopy - adverse effects
Ureteroscopy - methods
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Summary:Decision-making for complex pediatric urinary system stone disease is still a challenge for pediatric urologists. The interest in supine percutaneous nephrolithotomy (PCNL) is increasing among centers to achieve high surgical success rates with less morbidity. Despite advanced retrograde intrarenal surgery armamentarium, percutaneous approaches remain the first-line surgical treatment modality for >2 cm and complex renal stones. There are no comparative studies yet in the literature for pediatric endoscopic combined intrarenal surgery (ECIRS) In this study, we aimed to contribute to the literature by evaluating the safety and efficacy of ECIRS by comparing it with PCNL. Patients under 18 years of age who underwent PCNL and ECIRS for urinary tract stone disease at our Pediatric Urology department between 2012 and 2024 were included. Preoperative (demographic characteristics, stone characteristics, biochemical parameters), perioperative (duration of surgery, number of accesses, lasing and fluoroscopy times, endoscopic and fluoroscopic stone-free rates) and postoperative (hospital stay, urinary tract infection, complication and radiological stone-free rates) parameters were retrospectively evaluated. A total of 68 children [28 (41%) girls and 40 (59%) boys] aged 5 (0–17) years were included in the study. ECIRS was performed in 19 (28%), supine in 28 (41%) and prone PCNL in 21 (30%) patients. Age (p = 0.029), Guy's stone score (p 
ISSN:1477-5131
1873-4898
1873-4898
DOI:10.1016/j.jpurol.2024.05.025