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. 2022 May;40(5):1223-1229.
doi: 10.1007/s00345-022-03950-3. Epub 2022 Feb 7.

Outcomes and lessons learnt from practice of retrograde intrarenal surgery (RIRS) in a paediatric setting of various age groups: a global study across 8 centres

Ee Jean Lim  1 , Olivier Traxer  2 , Yesica Quiroz Madarriaga  3 , Daniele Castellani  4 , Khi Yung Fong  5 , Vinson Wai-Shun Chan  6 , Anna Bujons Tur  3 , Amelia Pietropaolo  7 , Deepak Ragoori  8 , Anil Shrestha  9 , Chandra Mohan Vaddi  10 , Tanuj Paul Bhatia  11 , Mriganka Mani  7 , Patrick Juliebø-Jones  7 , Stephen Griffin  7 , Esther García Rojo  12 , Mariela Corrales  2 , Cagri Akin Sekerci  13 , Yiloren Tanidir  13 , Jeremy Yuen-Chun Teoh  14 , Vineet Gauhar  15 , Bhaskar Kumar Somani  7
Affiliations

Outcomes and lessons learnt from practice of retrograde intrarenal surgery (RIRS) in a paediatric setting of various age groups: a global study across 8 centres

Ee Jean Lim et al. World J Urol. 2022 May.

Abstract

Purpose: To analyse and report the practice, outcomes and lessons learnt from a global series of retrograde intrarenal surgery (RIRS) in a paediatric multicentre series.

Methods: A retrospective review of anonymized pooled data gathered globally from 8 centres in paediatric patients (≤ 18 years of age) who had renal stones and underwent RIRS from 2015 to 2020 was performed. Patient demographics, perioperative parameters, stone characteristics, complications and stone-free rate (SFR; defined as endoscopically stone free and/or residual fragments < 2 mm on follow up imaging) were analysed. The cohort was stratified into 3 groups by age: < 5 years (Group A), 5-10 years (Group B) and > 10 years (Group C). Overall, post-operative complication rate was 13.7%. Chi-square comparisons were used for categorical variables; analysis of variance (ANOVA) or Kruskal-Wallis tests were used for continuous variables.

Results: 314 patients were analysed. The mean age was 9.54 ± 4.76 years. Groups A, B and C had 67 (21.3%), 83 (26.4%) and 164 (52.2%) patients, respectively. Mean stone size was 10.7 ± 4.62 mm. Pre-stenting was performed in 155 (49.4%) of patients, ureteral access sheaths (UAS) was used in 54.5% of patients with majority (71%) utilizing holmium laser for stone fragmentation. All complications were minor (Clavien-Dindo grade 1 and 2). SFR was 75.5%.

Conclusions: RIRS is acceptable as a first-line intervention in the paediatric population with reasonable efficacy and low morbidity. Complications are slightly higher in patients < 5 years of age, which should be taken into account while counselling patients.

Keywords: Paediatric; Renal calculi; Renal stone; Retrograde intrarenal surgery; Ureteroscopy.

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