Are small residual stone fragments really insignificant in children?

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dc.contributor.authorDincel, Nida
dc.contributor.authorResorlu, Berkan
dc.contributor.authorUnsal, Ali
dc.contributor.authorTepeler, Abdulkadir
dc.contributor.authorSilay, Mesrur Selcuk
dc.contributor.authorArmagan, Abdullah
dc.contributor.authorDiri, Akif
dc.date.accessioned2024-04-24T16:15:18Z
dc.date.available2024-04-24T16:15:18Z
dc.date.issued2013
dc.departmentDicle Üniversitesien_US
dc.description.abstractObjectives: To assess the significance of asymptomatic residual stone fragments of less than 4 mm (clinically insignificant residual fragments [CIRFs]) after shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), and retrograde intrarenal surgery (RIRS) in children. Patients and Methods: Eighty-five children were followed up for 6 to 50 months (median 22). Outcomes measured were fragment re-growth, stone events (emergency department visits, hospitalization, or additional interventions) and spontaneous fragment passage. Results: During follow-up, 22 children (25.8%) passed residual fragments spontaneously. Highest spontaneous passage rate was found for renal pelvis stones and the lowest for the lower pole stones (57.1% vs. 16.1%; p<0.001). When the number of the fragments increased, the chance of the spontaneous passage decreased (30% vs 20%; p<0.05). Symptomatic episodes including renal colic, hematuria, or urinary tract infection were documented in 34 (40%) patients, and re-growth of fragments was observed in 18 (21.2%). Stone size had no significant effect on spontaneous passage (p=0.079), stone growth (p=0.528), and symptomatic episodes (p=0.402). Twenty-five patients (29.4%) required secondary intervention for stone re-growth or stone related events and the remaining 20 patients (23.5%) needed medical treatment for bothersome symptoms or complications. Conclusions: Our results suggest that 40% of children with CIRFs will become symptomatic and 20% will develop stone re-growth over the following 6 months. Only one fifth of the fragments will pass spontaneously without any complications. Therefore, the use of the term CIRF is not appropriate for postoperative residual fragments in children. (c) 2013 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.jpedsurg.2012.07.061
dc.identifier.endpage844en_US
dc.identifier.issn0022-3468
dc.identifier.issue4en_US
dc.identifier.pmid23583144
dc.identifier.scopus2-s2.0-84876249712
dc.identifier.scopusqualityQ1
dc.identifier.startpage840en_US
dc.identifier.urihttps://doi.org/10.1016/j.jpedsurg.2012.07.061
dc.identifier.urihttps://hdl.handle.net/11468/15746
dc.identifier.volume48en_US
dc.identifier.wosWOS:000318681400031
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherW B Saunders Co-Elsevier Incen_US
dc.relation.ispartofJournal of Pediatric Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectChildrenen_US
dc.subjectFollow-Upen_US
dc.subjectResidual Fragmentsen_US
dc.subjectRenal Stoneen_US
dc.titleAre small residual stone fragments really insignificant in children?en_US
dc.titleAre small residual stone fragments really insignificant in children?
dc.typeArticleen_US

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