Which surgical method should be used in pediatric patients with a solitary kidney and 1–2 cm kidney stones?

Gurlen G., Aydamirov M., ALMA E., ALTUNKOL A., VURUŞKAN E., Karkin S., ...Daha Fazla

World Journal of Urology, cilt.43, sa.1, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s00345-025-06052-y
  • Dergi Adı: World Journal of Urology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Gender Studies Database, MEDLINE
  • Anahtar Kelimeler: Solitary kidney, Mini-percutaneous nephrolithotomy, Retrograde intrarenal surgery, Kidney stone
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Purpose: To evaluate and compare the efficacy and safety of retrograde intrarenal surgery (RIRS) and Mini-percutaneous nephrolithotomy (PCNL) in treating pediatric patients with solitary kidneys harboring medium-sized (1–2 cm) kidney stones. Methods: This study was conducted retrospectively. The two groups were compared in terms of surgical and postoperative parameters. Renal function was assessed both preoperatively and at the third month following surgery. Results: The mean age of patients in the mini-PCNL group was 13.5 ± 3.6 years, whereas that in the RIRS group was 10.7 ± 3.9 years (p = 0.772). The duration of fluoroscopy was significantly longer in the mini-PCNL group (126 ± 46.8 s) than in the RIRS group (55.3 ± 32.6 s) (p < 0.001). Conversely, the RIRS group had a longer operative time (58.3 ± 28.1 min) than did the mini-PCNL group (40.4 ± 19.2 min) (p = 0.028). At the one-month follow-up, stone-free rates were markedly higher in the mini-PCNL group (97.5%) than in the RIRS group (80.6%) (p < 0.001). There was no significant change in renal function following both surgeries. Conclusions: Mini-PCNL demonstrated superior outcomes in terms of stone clearance, reduced operative duration, and a lower need for subsequent procedures. In contrast, RIRS was associated with reduced fluoroscopy exposure and minimal blood loss, although it necessitated more frequent use of supplementary interventions.