MP23-19 LESSONS LEARNT FROM A MULTICENTER SERIES OF 400 CASES ON THE UTILITY OF PRE-STENTING FOR PEDIATRIC RETROGRADE INTRA RENAL SURGERY (RIRS)

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP23-19 LESSONS LEARNT FROM A MULTICENTER SERIES OF 400 CASES ON THE UTILITY OF PRE-STENTING FOR PEDIATRIC RETROGRADE INTRA RENAL SURGERY (RIRS) Ee Jean Lim, Stefania Ferreti, Anna Bujons, Olivier Traxer, Danielle Castellani, Yesica Quiroz, Deepak Ragoori, Tanuj Paul Bhatia, Chandra Mohan Vaddi, Claudia Gatti, Khi Yung Fong, Yiloren Tanidir, Bhaskar Kumar Somani, Anil Shrestha, and Vineet Gauhar Ee Jean LimEe Jean Lim More articles by this author , Stefania FerretiStefania Ferreti More articles by this author , Anna BujonsAnna Bujons More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , Danielle CastellaniDanielle Castellani More articles by this author , Yesica QuirozYesica Quiroz More articles by this author , Deepak RagooriDeepak Ragoori More articles by this author , Tanuj Paul BhatiaTanuj Paul Bhatia More articles by this author , Chandra Mohan VaddiChandra Mohan Vaddi More articles by this author , Claudia GattiClaudia Gatti More articles by this author , Khi Yung FongKhi Yung Fong More articles by this author , Yiloren TanidirYiloren Tanidir More articles by this author , Bhaskar Kumar SomaniBhaskar Kumar Somani More articles by this author , Anil ShresthaAnil Shrestha More articles by this author , and Vineet GauharVineet Gauhar More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003248.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retrograde intrarenal surgery (RIRS) is an option for pediatric kidney stone upto 1 cm in EAU guidelines and many urologist do RIRS for >1 cm stones as well if they have sufficient experience. We aim to assess the outcomes of pre-stenting versus non-pre-stenting in a pediatric population undergoing RIRS for intrarenal stones in different age groups and locations. METHODS: Data collected on Children/adolescents with kidney stones undergoing RIRS in 9 centers between 2015-2020 were retrospectively reviewed. Exclusion criteria: ureteral lithotripsy, bilateral procedures. Stone-free status was evaluated at 3-month and deemed as a single residual fragment (RF) ≤2 mm/absence of multiple fragments. Patients were divided into two groups (Group 1 no pre-stenting , Group 2 pre-stented). Student’s, Chi-square and Fisher’s exact test was used to assess difference between groups. Univariable and multivariable logistic regression analysis were performed to predict RF. Statistical signicance: p-value <0.05. RESULTS: 389 children/adolescents were included (192 patients in Group 1). Pre-stented patients were younger compared with non-presented (mean age 8.30±4.93 vs 10.43±4.30 years, p<0.001). There were no differences in stone characteristics (number, size, locations). Lasing and total surgical time were similar. Urinary tract infections (Clavien grade 2) were more prevalent in Group 2 (10.7%) compared to Group 1 (3.7%, p=0.016). Sepsis (Clavien grade 4) occurred in 2.1% of patients in Group 2 and no patient in Group 1 (p=0.146). 30.7% patients in Group 1 and 26.4% in Group 2 had RF (p=0.322). Multivariate logistic regression analysis showed that stone size was associated with RF (OR 1.20 95% CI 1.08-1.36, p=0.001). CONCLUSIONS: RIRS showed similar stone-free rate in pre and non-pre-stented children/adolescents, In this multicenter study, we found that preoperative positioning of ureteral stent had no effect in clearing stones but a higher incidence of postoperative infections. Whilst routine pre-stenting cannot be recommended it becomes imperative that the child's guardian is counseled appropriately about pros and cons of prestenting including need for additional anaesthesia. Source of Funding: NIL © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e314 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ee Jean Lim More articles by this author Stefania Ferreti More articles by this author Anna Bujons More articles by this author Olivier Traxer More articles by this author Danielle Castellani More articles by this author Yesica Quiroz More articles by this author Deepak Ragoori More articles by this author Tanuj Paul Bhatia More articles by this author Chandra Mohan Vaddi More articles by this author Claudia Gatti More articles by this author Khi Yung Fong More articles by this author Yiloren Tanidir More articles by this author Bhaskar Kumar Somani More articles by this author Anil Shrestha More articles by this author Vineet Gauhar More articles by this author Expand All Advertisement PDF downloadLoading ...