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Impact de l’acquisition d’un urétéroscope souple sur le traitement des calculs du haut appareil urinaire chez l’enfant [Impact of the acquisition of a flexible ureteroscope on the management of upper urinary tract stones in children]

Abstract : Introduction - Firstly reported in the early 1990s for the treatment of upper urinary tract stones in adult patients, flexible ureteroscopy (F-URS) has been used in children during the past 10 years and is now considered as a viable, but still second-line alternative to extracorporeal shockwave lithotripsy in these patients (ESWL). The aim of this study was to assess the impact of the acquisition of a F-URS on the management of upper urinary tract stones in children. Patients and methods - Data of all ESWL, F-URS and percutaneous nephrolithotomy performed for upper urinary tract stones in children from 0 to 18 years old in a single center from 2000 to 2014 have been collected retrospectively. Patients have been divided into two groups: group 1 before the acquisition of the F-URS (2000-2008) and group 2 after the acquisition of the F-URS (2008-2014). Preoperative data and peri-operative outcomes were compared between both groups using the χ(2) test and Fisher exact test for discrete variables and the Mann-Whitney test for continuous variables. Results - Thirty-seven children have been treated during the first era and 32 during the second one. The two groups were similar in terms of age (7.2 years vs 8.1 years; P=0.54), size of the largest stone (15 mm vs 16.2mm; P=0,56) and number of stones per patient (1.4 vs 2; P=0,07) but the sum of stone diameters was higher in group 2 (16.9 mm vs 24.2mm; P=0,048). The stone-free rates were comparable in both groups (28.1% vs 32.2% after the first procedure; P=0.72), as were the mean number of procedures per patient (2.4 vs 2.5; P=0.78), the total length of stay (2.7 days vs 2.9 days; P=0.77), and the number of patients who experienced at least one complication (37.8% vs 40.6%; P=0.87). Conclusion - The acquisition of a F-URS allowed the treatment of more complex stones with a similar efficacy and without increasing morbidity. Further studies are needed to define the role of F-URS in the management of upper urinary tract stones in children.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01260661
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Submitted on : Friday, January 22, 2016 - 2:40:18 PM
Last modification on : Thursday, July 30, 2020 - 3:18:02 PM

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L. Tondut, B. Peyronnet, A. Arnaud, L. Freton, J. Hascoet, et al.. Impact de l’acquisition d’un urétéroscope souple sur le traitement des calculs du haut appareil urinaire chez l’enfant [Impact of the acquisition of a flexible ureteroscope on the management of upper urinary tract stones in children]. Progrès en Urologie, Elsevier Masson, 2016, 26 (2), pp.96-102. ⟨10.1016/j.purol.2015.10.013⟩. ⟨hal-01260661⟩

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