Present Insights and Future Perspectives in Pediatric Percutaneous Nephrolithotomy: A Systematic Review by the EAU-YAU Pediatric Urology Working Group.

IF 2.8 2区 医学 Q1 UROLOGY & NEPHROLOGY
Journal of endourology Pub Date : 2025-07-01 Epub Date: 2025-05-07 DOI:10.1089/end.2024.0727
Yesica Quiroz Madarriaga, Muhammet İrfan Dönmez, Rianne J M Lammers, Beatriz Bañuelos Marco, Numan Baydilli, Edoardo Bindi, Simone Sforza, Lisette Aimée 't Hoen
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引用次数: 0

Abstract

Background and Objective: The incidence of stone disease in children has risen worldwide, leading to the development of more treatment options. Percutaneous nephrolithotomy (PCNL) is often the preferred approach in many pediatric cases. This systematic review aims to assess the effectiveness and safety of PCNL in children, as well as to identify future directions for improving procedural outcomes. Methods: For this systematic review a comprehensive electronic search was conducted in PubMed and EMBASE in August 2023. The search included patients younger than 18 with renal stones requiring any modality of PCNL, as well as to establish the deficiencies in the reports of outcomes. The search strategy adhered to PRISMA guidelines, and quality assessments were performed using the Cochrane tool and MINORS tool. Key Findings and Limitations: Regardless of age, PCNL is safe and efficient in children, with stone-free rate above 85% and complication rate below 7%. However, neither the definition of stone free nor the way of reporting complications is homogeneous among studies. In addition, aspects such as diagnostic imaging, antibiotic prophylaxis, postoperative drainage, metabolic study, or follow-up are not systematically or uniformly reported in the studies. Conclusions and Clinical Implications: PCNL maintains its efficiency and safety even when the working tract caliber is reduced. However, the lack of standardization when describing pre-, peri-, and postoperative aspects creates a gap that does not allow grouping outcomes and highlights the lack of clear guidelines when implementing this surgical procedure.

儿科经皮肾镜取石术的现状和未来展望:au - yau儿科泌尿外科工作组的系统综述。
背景与目的:世界范围内,儿童结石发病率上升,导致更多治疗选择的发展。经皮肾镜取石术(PCNL)通常是许多儿科病例的首选方法。本系统综述旨在评估PCNL在儿童中的有效性和安全性,并确定未来改善手术结果的方向。方法:本系统综述于2023年8月在PubMed和EMBASE中进行了全面的电子检索。该研究包括年龄小于18岁的肾结石患者,需要任何形式的PCNL,并确定结果报告中的缺陷。检索策略遵循PRISMA指南,使用Cochrane工具和未成年人工具进行质量评估。主要发现和局限性:无论年龄大小,PCNL在儿童中都是安全有效的,无结石率在85%以上,并发症发生率低于7%。然而,无论是无结石的定义还是报告并发症的方式在研究中都是不一致的。此外,诊断成像、抗生素预防、术后引流、代谢研究或随访等方面的研究没有系统或统一的报道。结论及临床意义:PCNL在工作道口径减小时仍能保持其有效性和安全性。然而,在描述术前、围手术期和术后方面缺乏标准化,导致无法对结果进行分组,并且在实施该手术过程中缺乏明确的指导方针。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of endourology
Journal of endourology 医学-泌尿学与肾脏学
CiteScore
5.50
自引率
14.80%
发文量
254
审稿时长
1 months
期刊介绍: Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes. The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation. Journal of Endourology coverage includes: The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions Pioneering research articles Controversial cases in endourology Techniques in endourology with accompanying videos Reviews and epochs in endourology Endourology survey section of endourology relevant manuscripts published in other journals.
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