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Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney

INTRODUCTION: Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS) in these children were determined. PATIENTS AND METHODS: Records of children with renal stones who were treated at our ins...

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Autores principales: Gamal, Wael Mohamed, Hussein, Mohamed M., Rashed, El Nisr, Mohamed, Al-Dahshoury, Mmdouh, Ahmed, Fawzy, Farag
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054661/
https://www.ncbi.nlm.nih.gov/pubmed/27843213
http://dx.doi.org/10.4103/0970-1591.189723
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author Gamal, Wael Mohamed
Hussein, Mohamed M.
Rashed, El Nisr
Mohamed, Al-Dahshoury
Mmdouh, Ahmed
Fawzy, Farag
author_facet Gamal, Wael Mohamed
Hussein, Mohamed M.
Rashed, El Nisr
Mohamed, Al-Dahshoury
Mmdouh, Ahmed
Fawzy, Farag
author_sort Gamal, Wael Mohamed
collection PubMed
description INTRODUCTION: Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS) in these children were determined. PATIENTS AND METHODS: Records of children with renal stones who were treated at our institute between August 2011 and August 2014 were retrospectively assessed. Inclusion criteria were: Children with single renal stone <2 cm size, in a solitary kidney. A 7.5 Fr flexible ureteroscope (FURS) was introduced into the ureter over a hydrophilic guidewire under visual and fluoroscopic guidance - applying a back-loading technique. The stone was completely dusted using 200 μm laser fiber (0.2–0.8 joules power and 10–30 Hz frequency). At the end of the maneuver, a 5 Fr JJ stent was inserted into the ureter. The children were discharged home 24 h postoperative - provided that no complications were detected. RESULTS: Fourteen children (3 girls and 11 boys) with median age 9.5 years (range 6–12) were included. The mean stone burden was 12.2 ± 1.5 mm (range 9–20). Stones were successfully accessed in all of the cases by the FURS except for 2 cases in whom a JJ stent was inserted into the ureter and left in place for 2 weeks to achieve passive dilatation. All of the stones were dusted completely. The immediate postoperative stone-free rate (SFR) was 79%, and the final SFR was 100% after 3 weeks. No intraoperative complications were observed. CONCLUSIONS: RIRS for renal stone <2 cm in children with a solitary kidney is a single-session procedure with a high SFR, low complication rate, and is a minimally invasive, natural orifice technique.
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spelling pubmed-50546612016-11-14 Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney Gamal, Wael Mohamed Hussein, Mohamed M. Rashed, El Nisr Mohamed, Al-Dahshoury Mmdouh, Ahmed Fawzy, Farag Indian J Urol Original Article INTRODUCTION: Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS) in these children were determined. PATIENTS AND METHODS: Records of children with renal stones who were treated at our institute between August 2011 and August 2014 were retrospectively assessed. Inclusion criteria were: Children with single renal stone <2 cm size, in a solitary kidney. A 7.5 Fr flexible ureteroscope (FURS) was introduced into the ureter over a hydrophilic guidewire under visual and fluoroscopic guidance - applying a back-loading technique. The stone was completely dusted using 200 μm laser fiber (0.2–0.8 joules power and 10–30 Hz frequency). At the end of the maneuver, a 5 Fr JJ stent was inserted into the ureter. The children were discharged home 24 h postoperative - provided that no complications were detected. RESULTS: Fourteen children (3 girls and 11 boys) with median age 9.5 years (range 6–12) were included. The mean stone burden was 12.2 ± 1.5 mm (range 9–20). Stones were successfully accessed in all of the cases by the FURS except for 2 cases in whom a JJ stent was inserted into the ureter and left in place for 2 weeks to achieve passive dilatation. All of the stones were dusted completely. The immediate postoperative stone-free rate (SFR) was 79%, and the final SFR was 100% after 3 weeks. No intraoperative complications were observed. CONCLUSIONS: RIRS for renal stone <2 cm in children with a solitary kidney is a single-session procedure with a high SFR, low complication rate, and is a minimally invasive, natural orifice technique. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC5054661/ /pubmed/27843213 http://dx.doi.org/10.4103/0970-1591.189723 Text en Copyright: © 2016 Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Gamal, Wael Mohamed
Hussein, Mohamed M.
Rashed, El Nisr
Mohamed, Al-Dahshoury
Mmdouh, Ahmed
Fawzy, Farag
Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
title Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
title_full Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
title_fullStr Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
title_full_unstemmed Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
title_short Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
title_sort pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054661/
https://www.ncbi.nlm.nih.gov/pubmed/27843213
http://dx.doi.org/10.4103/0970-1591.189723
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