Paediatric stone management: innovations and standards

Quhal, Fahad; Faddagh, Abdulmohsin Al; Sılay, Mesrur Selçuk; Straub, Michael; Seitz, Christian

doi:10.1097/mou.0000000000001004

Cited by 9 publications

(5 citation statements)

References 44 publications

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“…En los restantes 4 pacientes teniendo en cuenta la localización ureteral distal de los cálculos y su edad mayor se probó la terapia médica expulsiva (TME). Con lo cual la literatura refiere un aumento hasta 3 veces mayor en la tasa de expulsión de cálculos (22,23,49). Con respecto al manejo quirúrgico hasta el 22% de los niños con nefrolitiasis requerirán cirugía (23), hallazgos que fueron similares con el 28% reportado en nuestro estudio, siendo la litotripsia extracorpórea el procedimiento de primera elección en el 50%, modalidad que se recomienda como la mejor opción para el tratamiento de los cálculos piélicos y ureterales proximales menores a 2cm y en los menores de 1cm ubicados en cálices inferiores, con mayor porcentaje de curación a menor edad (23, 24,…”

Section: Discussionunclassified

Comparison of efficacy and safety of minimally invasive procedures for 10–20 mm pediatric renal Stones—A bayesian network meta-analysis

Zhao¹,

Tang³

et al. 2020

Journal of Pediatric Urology

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Section: Discussionunclassified

Comparison of efficacy and safety of minimally invasive procedures for 10–20 mm pediatric renal Stones—A bayesian network meta-analysis

Zhao¹,

Tang³

et al. 2020

Journal of Pediatric Urology

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“…The surgical options for pediatric urolithiasis are largely based on experiences and techniques used for the treatment of urolithiasis in adults [20]. The European Society for Paediatric Urology guidelines recommend PCNL as a mainline of treatment in renal stones larger than 2 cm in the renal pelvis or more than 1 cm in lower pole stones as well as staghorn stones [21].…”

Section: Percutaneous Nephrolithotomymentioning

confidence: 99%

Current evidence for suction in endourological procedures: comprehensive review of literature

Quhal

Zeng

Seitz

2022

Current Opinion in Urology

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Purpose of reviewTo identify the latest advances on the utilization of suctioning devices in the surgical treatment of urinary stones. Recent findingsAdvances are being made to incorporate suction and pressure control capabilities in percutaneous and ureteroscopic lithotripsy. Multiple retrospective studies and few prospective studies have shown that suctioning with minimally invasive percutaneous nephrolithotomy, commonly referred to as Super MiniPerc, can lead to better stone-free rates (SFR) and shorter operative time with lower incidence of infectious complications. Suctioning during retrograde intrarenal surgery (RIRS) has mainly been achieved through suctioning ureteral access sheath. Here as well, the incorporation of suction improved the SFR, but most importantly, reduced the risk of postoperative infectious complications. SummaryTheoretically suction in endourological procedures could facilitate stone debris removal and could reduce intrarenal pressure at the same time allowing for increased irrigation flow potentially decreasing operation time and infectious complications. These claims are supported in contemporary clinical studies, reporting superior SFR and reduced postoperative infectious complications in both percutaneous nephrolithotomy and RIRS.

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“…The management of ureteral stones in children includes open surgery, ureteroscopy (URS), extracorporeal shock-wave lithotripsy (ESWL), and percutaneous nephrolithotomy (PCNL). However, these procedures are costly and invasive and require anesthesia [ 6 ]. In recent years, MET (medical expulsive therapy) including alpha antagonists, steroids, and calcium channel blockers, has been used to enhance the distal ureteral stone expulsion rate in adults [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, these procedures are costly and invasive and require anesthesia [ 6 ]. In recent years, MET (medical expulsive therapy) including alpha antagonists, steroids, and calcium channel blockers, has been used to enhance the distal ureteral stone expulsion rate in adults [ 6 ]. Regarding the high risk of stone recurrence in patients, invasive treatments need repetition, and successful observations will be associated with less of a risk for urinary system manipulation and anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Medical Expulsive Therapy for Pediatric Ureteral Stones: A Meta-Analysis of Randomized Clinical Trials

Ziaeefar

Basiri

Zangiabadian

et al. 2023

JCM

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To evaluate the efficacy and safety of medical expulsive therapy (MET) for ureteral stones in pediatric patients, Cochrane, PubMed, Web of Science, Scopus, and the reference list of retrieved studies were searched up to September 2022 to identify RCTs on the efficacy of MET. The protocol was prospectively registered at PROSPERO (CRD42022339093). Articles were reviewed, data were extracted by two reviewers, and the differences were resolved by the third reviewer. The risk of bias was assessed using the RoB2. The outcomes, including the stone expulsion rate (SER), stone expulsion time (SET), episode of pain, analgesic consumption, and adverse effects, were evaluated. Six RCTs enrolling 415 patients were included in the meta-analysis. The duration of MET ranged from 19 to 28 days. The investigated medications included tamsulosin, silodosin, and doxazosin. The stone-free rate after 4 weeks in the MET group was 1.42 times that of the control group (RR: 1.42; 95% CI: 1.26–1.61, p < 0.001). The stone expulsion time also decreased by an average of 5.18 days (95% CI: −8.46/−1.89, p = 0.002). Adverse effects were more commonly observed in the MET group (RR: 2.18; 95% CI: 1.28–3.69, p = 0.004). The subgroup analysis evaluating the influence of the type of medication, the stone size, and the age of patients failed to reveal any impact of the aforementioned factors on the stone expulsion rate or stone expulsion time. Alpha-blockers as medical expulsive therapy among pediatric patients are efficient and safe. They increase the stone expulsion rate and decrease the stone expulsion time; however, this included a higher rate of adverse effects, which include headache, dizziness, or nasal congestion.

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Paediatric stone management: innovations and standards

Cited by 9 publications

References 44 publications

Comparison of efficacy and safety of minimally invasive procedures for 10–20 mm pediatric renal Stones—A bayesian network meta-analysis

Comparison of efficacy and safety of minimally invasive procedures for 10–20 mm pediatric renal Stones—A bayesian network meta-analysis

Current evidence for suction in endourological procedures: comprehensive review of literature

Medical Expulsive Therapy for Pediatric Ureteral Stones: A Meta-Analysis of Randomized Clinical Trials

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