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Endoscopic combined intrarenal surgery composed of micro-perc and retrograde intrarenal surgery in the treatment of complex kidney stones in children

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Abstract

Objective

This research aims to explore the efficiency and safety of endoscopic combined intrarenal surgery (Micro-ECIRS) composed of micro-percutaneous nephrolithotomy (Micro-perc) and retrograde intrarenal surgery (RIRS) in the Galdakao-modified supine Valdivia (GMSV) position for a single session for the treatment of complex nephrolithiasis in children.

Materials and methods

This study retrospectively reviewed patients aged < 18 years who underwent Micro-ECIRS in the GMSV position for renal stones larger than 2 cm under ultrasound guidance between August 2020 to May 2022 at our institution.

Results

A total of 13 patients (8 males and 5 females) received Micro-ECIRS for renal stones under ultrasound guidancewhile adopting the GMSV position. The average stone size was 2.7 cm (range: 2.1–3.7 cm). Among them, 6 patients had left kidney stones, 5 patients had right kidney stones, and 2 patients had bilateral kidney stones. The mean operative time was 70.5 min (range: 54–93 min). The mean hospital stay was 6.4 days (range: 4–9 days). The mean hemoglobin decrease was 8.2 g/L (range: 5.1–12.4 g/L). The total number of kidneys that had complete stone clearance was 8 kidneys at 48 h postoperatively, 11 kidneys at 2 weeks postoperatively, and 14 kidneys at 1 month postoperatively.

Conclusion

Our results demonstrate that Micro-ECIRS while patients are in the GMSV position is a safe and effective method for the treatment of complex children nephrolithiasis. However, all children made three hospital visits and received anesthesia three times. Further research is needed to confirm these findings.

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Funding

No specific grant was received by this study from any commercial or not-for-profit sectors, public funding agency.

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Author notes

  1. Zi-Hao Xu and Geng-Yu Du contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Pediatric Urolith Center, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310000, Zhejiang Province, China

    Zi-Hao Xu, Geng-Yu Du, Yi-Jun Zhao, Heng-You Wang, Guang-Jie Chen, Chang Tao & Xiang Yan

Authors
  1. Zi-Hao Xu
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  2. Geng-Yu Du
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  3. Yi-Jun Zhao
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  4. Heng-You Wang
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  5. Guang-Jie Chen
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  6. Chang Tao
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  7. Xiang Yan
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Contributions

XY: Project development. GJC, CT, YJZ and HYW: Data collection. ZHX and GYD: Data analysis and manuscript writing.

Corresponding author

Correspondence to Xiang Yan.

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The authors declare no competing financial interests.

Ethical standards

All procedures conducted in studies with participants involved complied with the 1964 Helsinki declaration and its later amendments and comparable ethical standards, and with the ethical standards of the Children's Hospital of Zhejiang University School of Medicine.

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All individual participants gave informed consent.

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Xu, ZH., Du, GY., Zhao, YJ. et al. Endoscopic combined intrarenal surgery composed of micro-perc and retrograde intrarenal surgery in the treatment of complex kidney stones in children. World J Urol 42, 21 (2024). https://doi.org/10.1007/s00345-023-04695-3

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  • DOI: https://doi.org/10.1007/s00345-023-04695-3

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