Publication: Outcomes and lessons learnt from practice ofretrograde intrarenal surgery (rirs) in a paediatricsetting of various age groups: a global study across 8 centres
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Date
2022-05-13
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Abstract
INTRODUCTION AND OBJECTIVE: We aim 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: Retrospective review of anonymised 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) were analysed.
Residual fragments(RFs) were defined as a single fragment >2mm or
multiple fragments. Our cohort was stratified by age into 3 groups
: 5 years (Group A), 5-10 years (Group B) and 10 years (Group
C). T-test and ManneWhitney were used for continuous variables.
Categorical data between groups were analysed using the c2 test.
RESULTS: 314 patients were included for analysis. Mean age
was 9.54 þ/- 4.76 years. The number of patients in groups A, B and C
were 67 (21.3%), 83 (26.4%) and 164 (52.2%) respectively. The mean
stone size was 10.7 þ/- 4.62 mm. While pre-stenting was performed in
155 (49.4%) of patients, ureteral access sheaths (UAS) was used in
54.5% of patients, and majority (71%) utilizing holmium laser for
stone fragmentation. The SFR was 75.5% with 77(24.5%) having
residual fragments. All post-surgical complications were minor Clavein
Dindo (CD) classification and included ureteric injury (n[5),
pelvicalyceal injury (n[5, all in group A), fever (n[20), hematuria (n
[11) and sepsis (n[2).
CONCLUSIONS: RIRS is acceptable as a firstline intervention
in the paediatric population with reasonable efficacy and low morbidity;
Complications are slightly higher in Group A and this should be taken
into account while counselling patients.
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Keywords
Tıp, Cerrahi Tıp Bilimleri, Üroloji, Pediatrik Üroloji, Sağlık Bilimleri, Medicine, Surgery Medicine Sciences, Urology, Pediatric Urology, Health Sciences, Klinik Tıp (MED), Klinik Tıp, ÜROLOJİ VE NEFROLOJİ, CERRAHİ, Clinical Medicine (MED), CLINICAL MEDICINE, UROLOGY & NEPHROLOGY, SURGERY, Cerrahi, Nefroloji, Surgery, Nephrology
Citation
Lim E. J., Traxer O., Madarriaga Y. Q., Castellani D., Fong K. Y., Shun Chan V. W., Tur A. B., Pietropaolo A., Ragoori D., Shrestha A., et al., \"OUTCOMES AND LESSONS LEARNT FROM PRACTICE OFRETROGRADE INTRARENAL SURGERY (RIRS) IN A PAEDIATRICSETTING OF VARIOUS AGE GROUPS: A GLOBAL STUDY ACROSS8 CENTRES\", AUA 2022, Louisiana, Amerika Birleşik Devletleri, 13 Mayıs - 16 Haziran 2022, cilt.207, ss.288