Chen Y, et al. - Researchers undertook a comparative scrutiny of the efficacy and safety of the percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in the surgical treatment of pediatric patients with upper urinary stones. In selected cases, RIRS was discovered to be a safe and feasible procedure alternative to PCNL for children with upper urinary stones.

Methods

• In order to identify studies comparing outcomes of PCNL and RIRS for treating pediatric patients with upper urinary stones, researchers examined the Pubmed, Embase, Cochrane Library and CNKI before May 2017.
• The design of this research was a systematic review study.
• It consisted of 11 studies, with the inclusion of 1 randomized controlled trial, 4 retrospective case-control studies and 6 case series studies, containing 822 children with upper urinary stones.
• Five of 11 including studies, containing 474 children with upper urinary stones constituted the meta-analysis.

Results

• Data reported substantially shorter hospital stay and fluoroscopy time due to RIRS than PCNL (WMD: 1.44 days, 95% CI 0.85, 2.04; p < 0.00001) and (WMD: 72.72 s, 95% CI 52.13, 93.31; p < 0.00001).
• Findings brought to light the higher overall complications for PCNL compared with RIRS (OR 1.70, 95% CI 1.02, 2.84; p=0.04).
• Nonetheless, higher minor (Clavien I or II) and major (Clavien III-V) complications rates were disclosed in the PCNL group than with RIRS group, however, the variations were not statistically marked (p > 0.05).
• The advantage of RIRS was attributed to considerably less need for blood transfusion (OR 9.09, 95% CI 1.66, 49.78; p=0.01).
• Experts did not discover any prominent variations in initial, final stone-free rate, and operative times (p > 0.05).