Extracorporeal Shockwave Lithotripsy Versus Flexible Ureteroscopy for the Management of Upper Tract Urinary Stones in Children
| Autor: | Benoit Peyronnet, Benjamin Pradere, Lucas Freton, Gregory Verhoest, Edouard Habonimana, B. Fremond, Karim Bensalah, Olivier Azzis, L. Tondut, Juliette Hascoet, Alexis Arnaud |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Urology Urinary system medicine.medical_treatment 030232 urology & nephrology Flexible ureteroscopy Kidney Kidney Calculi 03 medical and health sciences Extracorporeal shockwave lithotripsy 0302 clinical medicine Ureter Urolithiasis Lithotripsy Ureteroscopy medicine Humans Child Retrospective Studies medicine.diagnostic_test business.industry Infant Newborn Infant Perioperative Extracorporeal shock wave lithotripsy Surgery medicine.anatomical_structure Upper tract Child Preschool 030220 oncology & carcinogenesis Multivariate Analysis Ureteroscopes Female business |
| Zdroj: | Journal of Endourology. 31:1-6 |
| ISSN: | 1557-900X 0892-7790 |
| DOI: | 10.1089/end.2016.0313 |
| Popis: | To compare the efficacy and morbidity of extracorporeal shockwave lithotripsy (SWL) and flexible ureteroscopy (F-URS) for the management of upper tract urinary stones in children.All SWL and F-URS performed in children in a single institution between 2000 and 2014 were reviewed retrospectively. Only procedures performed to treat upper tract urinary stones (upper ureter or kidney) were included in this study. Preoperative and perioperative outcomes were compared between the SWL and F-URS groups. Univariate and multivariate logistic regression analyses were used to evaluate predictors of stone-free (SF) status.Over the study period, 100 SWL and 46 F-URS were conducted in 69 children. The SWL and F-URS groups were comparable in terms of stone size (14.6 vs 13.2 mm, p = 0.32), but there were more multiple stones (31% vs 57%; p = 0.003) and lower pole calculi (14% vs 37%; p = 0.003) in the F-URS group. The SF rate after one procedure was almost two times higher in the F-URS group compared with the SWL group (37% vs 21%; p = 0.04) without increasing the complication rate (21.7% vs 16%; p = 0.31). Similar results were observed in the subgroup of single renal stones20 mm (SF rates: 78.6% vs 50%; p = 0.06). In multivariate analysis, the use of F-URS vs SWL was a predictor of an SF status (odds ratio = 3.7; p = 0.02).F-URS provides a higher single-session SF rate, despite more complex urinary stones (multiple, lower pole, etc.) and without increasing morbidity. |
| Databáze: | OpenAIRE |
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