Ain Shams University Hospital, Cairo, Egypt.
World J Urol. 2022 Dec;40(12):3083-3089. doi: 10.1007/s00345-022-04186-x. Epub 2022 Oct 16.
We aimed to compare the cost-effectiveness and safety of retrograde intrarenal surgery (RIRS) and mini-percutaneous nephrolithotomy (mini-PCNL) for pediatric kidney stones management.
Ninety pediatric patients with single or multiple renal stones 1-3 cm in diameter were collected prospectively and equally divided into two groups to undergo RIRS or mini-PCNL. The groups were compared for fluoroscopy and operative time, postoperative hospital stay time, stone-free rate (SFR), need for auxiliary procedures, and cost as well as complications.
There were no differences found between RIRS and mini-PCNL groups with regard to operative time and postoperative DJ stent application, while the mean of fluoroscopy time and postoperative hospital stay was significantly shorter in the RIRS than in the mini-PCNL group. The SFR, auxiliary treatment on residual stones, and complications were comparable. In both groups, no major (Clavien IV-V) complications were observed. The mean cost of RIRS was $1210 and $733 for the mini-PCNL.
Both RIRS and mini-PCNL are effective and safe treatment modalities for pediatric renal stones 10-30 mm in size. However, mini-PCNL is more cost-effective making it a viable alternative to RIRS.
本研究旨在比较逆行肾盂内碎石术（RIRS）和迷你经皮肾镜碎石术（mini-PCNL）治疗小儿肾结石的成本效果和安全性。
前瞻性收集了 90 例 1-3cm 直径的单发或多发肾结石的小儿患者，将其平均分为 RIRS 组和 mini-PCNL 组，比较两组的透视时间和手术时间、术后住院时间、结石清除率（SFR）、辅助治疗需要以及成本和并发症。
RIRS 组和 mini-PCNL 组的手术时间和术后 DJ 支架应用无差异，而 RIRS 组的透视时间和术后住院时间明显短于 mini-PCNL 组。SFR、残余结石的辅助治疗和并发症相当。两组均未观察到严重（Clavien IV-V）并发症。RIRS 的平均费用为 1210 美元，mini-PCNL 的费用为 733 美元。
RIRS 和 mini-PCNL 均是治疗 10-30mm 小儿肾结石有效且安全的方法，但 mini-PCNL 更具成本效益，是 RIRS 的可行替代方法。
