Outcomes of Paediatric Cystine Stone Management: Results of a Systematic Review.

IF 2.5 2区医学 Q2 UROLOGY & NEPHROLOGY

Current Urology Reports Pub Date : 2023-08-01 DOI:10.1007/s11934-023-01162-9

Francesco Ripa, Amelia Pietropaolo, Robert Geraghty, Stephen Griffin, Paul Cook, Bhaskar Somani

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引用次数: 0

Abstract

Purpose of review: We wanted to analyse the outcomes of surgical (SWL, URS, PCNL) and medical management of cystine stones in the paediatric population in terms of stone-free status and complication rates, based on all the available literature evidence.

Recent findings: A systematic review of literature was performed for all studies with paediatric cystine stone management. Twelve studies met the eligibility criteria, of which 4 analysed outcomes of SWL, 2 of URS and 3 of PCNL and 3 focused on the effect of either alkalising agents (potassium citrate, citric acid) or cysteine-binding thiol (CBT) agents (tiopronin, penicillamine). The reported SFR in studies ranged from 50 to 83%, 59 to 100% and 63 to 80.6%, with a complication rate of 2.8-51%, 14-27% and 12.9-15.4% with SWL, URS and PCNL, respectively. Paediatric cystine stones treatment should aim at complete stone clearance, preservation of renal function and prevention of further recurrences. SWL achieves inferior results in case of cystine stones. URS and PCNL are safe and effective procedures in the paediatric population, with a low rate of major complications. Adherence to medical prevention therapies may prolong recurrence-free periods.

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儿科胱氨酸结石治疗的结果:一项系统评价的结果。

回顾的目的:我们希望根据所有可用的文献证据，分析儿科人群中胱氨酸结石的手术(SWL、URS、PCNL)和医疗管理的结果，包括无结石状态和并发症发生率。最近的发现:对所有关于小儿胱氨酸结石管理的研究进行了系统的文献回顾。12项研究符合入选标准，其中4项研究分析了SWL的结果，2项研究分析了URS的结果，3项研究分析了PCNL的结果，3项研究关注了碱化剂(柠檬酸钾、柠檬酸)或半胱氨酸结合硫醇(CBT)剂(硫丙肽、青霉胺)的效果。研究报告的SFR为50 ~ 83%、59 ~ 100%和63 ~ 80.6%，SWL、URS和PCNL的并发症发生率分别为2.8 ~ 51%、14 ~ 27%和12.9 ~ 15.4%。小儿胱氨酸结石的治疗应以完全清除结石、保存肾功能和预防进一步复发为目标。在胱氨酸结石的情况下，SWL的效果较差。URS和PCNL在儿科人群中是安全有效的手术，主要并发症发生率低。坚持医学预防疗法可延长无复发期。

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来源期刊

Current Urology Reports UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

3.80%

发文量

期刊介绍： This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.