142 / 492
S10: ENDOUROLOGY
Moderators: Eugene Minevich (USA), Simona Gerocarni Nappo (Italy)
ESPU Meeting on Thursday 15, October 2015, 14:34 - 15:00
14:34 - 14:39
S10-1
(LO)
★
RETROGRADE INTRARENAL SURGERY VERSUS PERCUTANEOUS
NEPHROLITHOTOMY IN THE MANAGEMENT OF LARGE UPPER URINARY TRACT
STONES IN CHILDREN: A RANDOMIZED CLINICAL TRIAL
Ahmed HANNO, Karim SAAD, Seif Al Islam NAFIS and Mohamed YOUSSIF
FACULTY OF MEDICINE, UNIVERSITY OF ALEXANDRIA, Urology, Alexandria, EGYPT
PURPOSE
To compare the outcomes of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the
treatment of children with renal and upper ureteric calculi of more than 2 cm in maximum dimension.
MATERIAL AND METHODS
Between May 2011 and February 2014, 38 children with renal and upper ureteric calculi more than 2 cm in maximum
dimension were prospectively randomized between RIRS (group A) and PCNL (group B). Age ranged from 1 year and 5
months to 16 years in the whole studied population. Sex distribution, laterality, incidence of recurrent stones and stone
characteristics were comparable between the two groups.
RESULTS
The study included 43 renal units; 21 units in group A and 22 units in group B. The mean radiation time and hospital
stay were longer, but the stone free rate was higher in group B (95.5% versus 80.9%, P = 0.185). Patients in PCNL
group had a statistically significant higher complication rate compared with RIRS group (P=0.018). Three patients in the
PCNL group received blood transfusions, whereas none of the children in the RIRS group were transfused (P = 0.015).
One patient had a pneumothorax and one had an injury of the ileum in the PCNL group. The only complication in the
RIRS group was postoperative fever (one patient).
CONCLUSIONS
This study demonstrates that RIRS is an effective, appreciably safer alternative to PCNL in pediatric patients with large-
sized upper tract stones. Radiation exposure, hospital stay, and morbidities of PCNL can be significantly reduced with
the RIRS technique.